Technique of nonvascularized toe phalangeal transfer and distraction lengthening in the treatment of multiple digit symbrachydactyly

A combination of nonvascularized multiple toe phalangeal transfers, web space deepening, and distraction lengthening may provide excellent function in the child born with the oligodactylous type of symbrachydactyly. These techniques may reconstruct multiple digits, maintaining a wide and stable grip span with good prehension to the thumb.We detail the techniques of each of these 3 stages in reconstruction and describe appropriate patient selection. Potential complications are discussed. However, with strict attention to technical details, these complications can be minimized.