Background
Vascularized toe proximal interphalangeal joint transfer provides a functional restoration for post-traumatic finger joints with a stable and mobile joint. However, one of the commonest observations is the significant extension lag after the vascularized joint transfer (VJT). In the past, modified Stack’s procedure was performed for the central slip reconstruction of a Boutonneire deformity. In the earlier practices of our senior author, Stack’s procedure was accommodated to the VJT. Lately, Te technique has been proposed for correcting the issue of extension lag. The aim of this study is to compare the long-term follow-up outcome between modified Stack’s and Te technique in VJTs.

Patients and Methods
From May 2009 to October 2021, 48 digits in 45 patients (33 males and 12 females) underwent free vascularized toe joint transfer for post-traumatic damaged proximal interphalangeal joint. The mean age was 31.5 years (range, 5 to 50 years), with 24 right and 24 left hands. In all type I toe, eight digits with modified Stack’s method and 40 digits with Te technique for central slip reconstruction.
Results
The average length of follow-up was 29.6 months (range, 4 to 78 months). The mean extension lag was 20.8 degrees and the flexion was 77.4 degrees. The range of motion was 56.8 degrees which accounting for 77.4 percent functional use of pretransfer toe proximal interphalangeal joint passive range of motion. There was no significant difference in reconstructed proximal interphalangeal joint in extension lag (25 vs. 20 degrees, p = 0.44), flexion (75 vs. 80 degrees, p = 0.38) and the range of motion (52.5 vs. 57.5 degrees, p = 0.33) between modified Stack’s method and Te technique.
Conclusions:
For central slip reconstruction in type I toe with poor lateral band, Te technique provides a reliable and reproducible method for correcting extension lag in vascularized joint transfer. Besides, this technique also presented favorable long-term outcomes comparable to modified Stack’s method.

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