Pre and post operative occupational therapy for a toe to hand transplantation

Thumb loss is a significant disability for the hand. This paper describes a traumatic thumb injury and amputation after which the occupational therapist placed an orthotic device to substitute for the thumb. When the patient was undecided about a proposed toe-to-hand transplant, the occupational therapist fabricated a mold of the toe, and attached it to the patient's hand. After training with the mold, the patient was ready to accept the toe-to-hand transplant. The post transplant occupational therapy program and patient's return to work was described.