A double toe-to-hand transfer in a young girl

A 14 years old girl lost all the fingers of her right hand except the thumb in a Toka (fodder chopping machine) 4 months ago. The fingers had been amputated at the level of the metacarpophalangeal joint. A double toe transfer was done using the second and third toes of her right foot to reconstruct the second and third digits of her right hand using microvascular technique. Bones were fixed with K-wires, corresponding tendons and nerves were attached, the dorsalis pedis artery was anastamosed end-to-side to the radial artery and the vein was anastamosed to the cephalic vein. The patient recovered well. K-wires were removed at 6 weeks and physiotherapy was started. After 4 months, the patient was able to use the hand for normal hand function and could make a tripod pinch.