{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T17:01:11Z","timestamp":1785085271918,"version":"3.55.0"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Vascularized toe proximal interphalangeal (PIP) joint transfer restores motion after destructive finger injuries, yet outcomes are limited by a persistent extensor lag. We observed subtendinous connective tissue attachment beneath the extensor digitorum longus (EDL), from the proximal phalangeal neck to the PIP joint, that may tether the tendon to bone. We assessed whether releasing this tissue improves surgical outcomes without compromising perfusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a retrospective matched cohort study with a 1:1 propensity score matching on sex, age at surgery, native toe passive range of motion (ROM) and follow-up duration, comparing transfers with subtendinous tissue dissection to cases without dissection. Matched cohorts included 17 dissected and 17 non-dissected joints. The primary outcome was extension lag of the transferred PIP joint at final follow-up. Secondary outcomes included active PIP joint ROM, active flexion, percentage of use (active ROM \u00f7 donor toe passive ROM \u00d7100), revision incidence and number of revision procedures per patient. Early follow-up was defined as 6\u2009months postoperatively, and final follow-up as the most recent outpatient visit. Patients with follow-up &lt;12\u2009months were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At the 6\u2009month postoperative assessment, prior to any revision procedures, the dissected group demonstrated less extension lag (15\u00b0 vs. 20\u00b0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.014) and greater ROM (55\u00b0 vs. 45\u00b0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.017). At final follow-up, extension lag remained less (15\u00b0 vs. 20\u00b0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.032), whereas ROM, flexion and percentage of use did not differ. The revision burden was similar between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Donor-side release of the subtendinous tissue beneath the EDL was associated with reduction in early and final extension lag without vascular compromise. These findings should be interpreted cautiously and warrant confirmation in larger studies with longer follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>III<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17531934261459371","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:31:56Z","timestamp":1784878316000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of subtendinous connective tissue restraints on extension of the vascularized toe joint transfer: a propensity score-matched comparison"],"prefix":"10.1177","author":[{"given":"Soo Jin","family":"Woo","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"W Institute for Hand and Reconstructive Microsurgery, W General Hospital, Daegu, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che-Hsiung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"International Master Science Program in Reconstructive Microsurgery, Chang Gung University, College of Medicine, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren-Wen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"International Master Science Program in Reconstructive Microsurgery, Chang Gung University, College of Medicine, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"W Institute for Hand and Reconstructive Microsurgery, W General Hospital, Daegu, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Heng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"International Master Science Program in Reconstructive Microsurgery, Chang Gung University, College of Medicine, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Te","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"International Master Science Program in Reconstructive Microsurgery, Chang Gung University, College of Medicine, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196704000-00001"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.09.010"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(98)80123-8"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714546189"},{"key":"e_1_3_3_6_1","volume-title":"Sarrafian\u2019s anatomy of the foot and ankle: descriptive, topographic, functional","author":"Kelikian AS","year":"2011","unstructured":"Kelikian AS, Sarrafian SK. Myology. In: Sarrafian\u2019s anatomy of the foot and ankle: descriptive, topographic, functional. Philadelphia, Lippincott Williams & Wilkins, 2011: 228\u201332."},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31829589db"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193419857475"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000009529"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31818d69c3"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196951040-00005"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31829589bd"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558944720988081"}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261459371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17531934261459371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261459371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T16:56:50Z","timestamp":1785085010000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17531934261459371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":12,"alternative-id":["10.1177\/17531934261459371"],"URL":"https:\/\/doi.org\/10.1177\/17531934261459371","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"article-number":"17531934261459371"}}