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Digital Transposition in the Injured Hand
PAUL D. HARKINS; JOHN E. RAFFETY
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From the Orthopaedic Service, Walter Reed General Hospital, Washington, D. C.
1972 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1972; 54:1064-1069 
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Abstract

1. In twenty of twenty-one cases of transposition of a digit to replace an amputated thumb the results were excellent or satisfactory as to pinch, opposition, and sensibility.

2. The damaged or least useful remaining damaged digit should be used for pollicization when possible.

3. Digital transfers can be safely performed with a single intact digital artery and even on a metacarpal artery in the case of the index finger in the absence of functioning digital arteries.

4. Preservation of a dorsal vein is desirable but not essential in digital transposition. It is difficult when the long finger is transferred and impossible for the ring finger.

5. The presence of a remnant of the thumb metacarpal facilitates the procedure and greatly improves the results.

6. The position of rotation of the pollicized digit is best determined by the orientation of the remnants of metacarpal and thenar mass. When thenar muscle mass and metacarpal are not present, rotation should approximate 120 degrees to the digital plane.

7. Secondary procedures are to be expected in the reconstruction program and pollicization is but one of the essential procedures in the process of rehabilitation of a severely damaged hand.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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