What are free non-vascularised toe phalangeal grafts?

Free non-vascularised toe phalangeal grafts are a treatment option for aphalangia, a congenital hand defect where a child is born with missing bones in their fingers. The treatment involves taking bones from the toes (toe phalanges) to repair the aphalangia and lengthen the fingers in the hand without surgically connecting blood vessels, that's why it is non-vascularised.

Free non-vascularised toe phalangeal grafts, or transplants, can help ensure that children suffering from aphalangia develop motor skills as they grow. The procedure lengthens short and unusable fingers to help children grasp small objects. The bones taken from the toes can still grow when they are transplanted to the hands, this, in turn, allows children to write and perform other exercises with their hands that they would not have otherwise not been able to do. Through free non-vascularised toe phalangeal grafts, children have a better chance of having normal use of their hands.

How are free non-vascularised toe phalangeal graft surgeries performed?

To perform free non-vascularised toe phalangeal graft surgery, Dr Carter will first have to examine the child through a series of tests and x-rays. This will help Dr Carter determine how many toe phalanges will be needed to help improve the use of the affected hand, or hands.

During the procedure, Dr Carter will remove the toe phalanges from the foot and insert them into the hand. Usually, the foot opposite the affected hand is used, but this is not always the case. Free non-vascularised toe phalangeal graft surgery is performed under general anaesthetic when a child is 1 year old to ensure that the transplanted bones can grow effectively. It is important that the procedure is done at an early age (1-year-old) to retain maximum ability for the toe to grow. Children are able to walk and stand at least four days after the procedure but will need time to heal before they have full use of their hands.