Preoperative and postoperative gait analyses of patients undergoing great toe-to-thumb transfer.

Microvascular transfer of the great toe is a reliable method of thumb reconstruction for many patients, but the precise deficit incurred by elective amputation of the great toe has not been fully defined. Twelve patients who had this procedure were evaluated with preoperative and postoperative gait analyses and clinical examinations. The mean age was 29.3 years, with a mean clinical follow-up of 30.3 months, and a comparative follow-up gait study at a mean of 21.1 months postoperatively. Only one patient exhibited a significant motion change postoperatively, which was a reduction in ankle plantar-flexion at weight release of the operated foot (push-off). The average velocity, cadence, step length of the foot that had surgery performed, single and double limb stance times of each foot, and step width did not significantly change. There was only a slight average reduction in stride length at 4.6% (p less than 0.05), which resulted from a decrease in step length of the foot that did not have surgery 7.6% (p less than 0.02). Nine patients had no clinical complaints, two had occasional mild discomfort near the second and third metatarsal heads, and one had intolerance to cold.