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أدناه يمكنك قراءة الترجمة الإنجليزية لهذا المحتوى المترجم بواسطة مترجم بشري. يمكنك أيضًا عرض الأصل باللغة الإسبانية من خلال النقر على العلم المقابل في الزاوية اليمنى العليا. يتيح لك هذا الرابط الوصول إلى نسخة من الترجمة الآلية من Google للعربية: https://bit.ly/3wmJ0s6
Dr Francisco del Piñal is a world reference in the execution of toe to hand transplants. The Spanish surgeon has performed more than 500 microsurgical procedures of these characteristics, with a success rate over 99%, restoring function in their upper extremity to patients with different degrees of mutilations.
In this new entry in his videoblog, Piñal analyzes the indications for this technique, his contributions to its development, as well as four case studies that reflect various clinical situations.
The surgeon presents the applications of the procedure in accidental loss of the thumb and / or triphalangeal fingers or long fingers, as well as in patients with congenital defects in which these have not reached a normal development (in pathologies such as symbrachydactyly or thumb hypoplasia, for example).
In turn, Piñal advocates resorting to toe to hand transfer in the period closest to losses in the hand, since this allows the use of preserved osteotendinous and muscular structures in the reconstruction of the hand or the re-motorization of the affected thumb. However, he assures that this type of intervention can be carried out several years after the trauma.
Dr. Piñal points out the big toe as the ideal one for thumb reconstructions, detailing the bone and skin reduction surgery to achieve a very similar appearance between the lost finger and the transplanted toe; while the second toes of each foot are the most used in cases of long finger mutilation. Along these lines, he establishes the recuperation of the arch of the hand as the key to recovery for the patient, not only aesthetic but also functional.
Piñal, one of the surgeons with the largest number of procedures performed in this field in the world, highlights among his main contributions to medical knowledge in toe to hand transplantations the introduction of this technique in the reconstruction and recovery of long fingers; a contribution reflected almost two decades ago in two separate articles. Firstly, for the journal of the American Society of Plastic Surgeons, ‘Plastic and Reconstructive Surgery’: ‘Minimizing Impairment in Laborers with Finger Losses Distal to the Proximal Interphalangeal Joint by Second Toe Transfer’ (PRS Vol. 112 No. 4 pp. 1000-1011 September 2003) and secondly for the British and European volumes of the ‘Journal of Hand Surgery’: ‘The Indications for Toe Transfer after “Minor” Finger Injuries’ (The Journal of Hand Surgery, British and European Volume, 29B:2 pp. 120-129 April 2004).
Likewise, he underscores his advances in the approach to massive losses of the thumb, in which the damage extends beyond the finger and reaches the palm of the hand. These works are collected, for example, in his 2019 article ‘Extreme Thumb Losses: Reconstructive Strategies‘, published by ‘Plastic and Reconstructive Surgery’. The prestigious US publication selected Dr Piñal’s paper as the best of the year in the hand category.
On the other hand, the Spanish surgeon considers that experience and technical knowledge are a guarantee to carry out this type of intervention to a successful conclusion, in addition to emphasizing the low impact on the donor foot, which does not cause functional limitations in the daily life of patients.
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