Patient-Reported Outcome Measures for Toe-to-Hand Transfer: A Prospective Longitudinal Study

Area of Science:

• Orthopedic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Patient-reported outcome measures (PROMs) are crucial for evaluating reconstructive surgery efficacy.
• Toe-to-hand transfer restores prehensile function but involves complex procedures and rehabilitation.
• Concerns exist regarding donor-site morbidity and functional outcomes of toe-to-hand transfer.

Purpose of the Study:

• To longitudinally assess the patient-reported benefits of toe-to-hand transfer.
• To evaluate functional and psychosocial outcomes using validated questionnaires.
• To compare outcomes between dominant and nondominant hand reconstructions.

Main Methods:

• Prospective evaluation of 23 patients undergoing free toe-to-hand transfer (2012-2015).
• Utilized Michigan Hand Outcomes Questionnaire, SF-36 Health Survey, and Lower Limb Outcomes Questionnaire pre- and post-operatively.
• Performed subgroup analysis for dominant vs. nondominant hand reconstruction.

Main Results:

• Significant improvements in Michigan Hand Outcomes Questionnaire scores for daily living, work, aesthetics, and satisfaction (p < 0.05).
• Significant improvements in SF-36 physical and emotional role functioning (p < 0.05).
• No significant deterioration in lower limb function (p = 0.55); greater benefits observed in dominant hand reconstructions.

Conclusions:

• Toe-to-hand transfer demonstrates significant functional and psychosocial utility.
• Reconstruction of the dominant hand yields greater patient-reported benefits.
• Donor-site morbidity is generally well-tolerated, supporting the procedure's value.