[Toe-to-hand transfer in thumb and finger reconstruction in 6 cases without a dorsalis pedis]

Absence of dorsalis pedis artery in 6 feet of 6 patients was found in 160 feet of 148 cases operated upon for toe-to-hand transfer, rating 3.8%. In such a transfer, the first dorsal metatarsal artery, or the first plantar metatarsal artery, if the former was also absent, which was always larger than usual, was dissected out and cut off at its origin. Being the nutrient vessel for the transfer, it was anastomosed to the distal segment of the radial artery at or beyond the anatomic snuffbox. Otherwise, vein grafting was done to bridge the gap in between, or direct anastomosis of the common digital arteries of the toe with that of the thumb or finger (s) might be carried out. In case necessary for 2 or more toe-units, the first dorsal metatarsal and the first plantar metatarsal arteries were anastomosed to radial artery in a paralleled fashion to feed the transplants with one recipient artery. The operations were success in 5 patients and failed in 1. The technical detail and the benefits of this method are discussed.