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Simultaneous multiple toe transfers in hand reconstruction.

F C Wei¹, H C Chen, C C Chuang

¹Department of Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.

Plastic and Reconstructive Surgery

|March 1, 1988

Summary

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Simultaneous toe transfers for hand reconstruction are feasible and effective, even with multiple missing digits. This technique offers functional restoration without significant complications, proving both time- and cost-effective.

Area of Science:

Microsurgery
Reconstructive Surgery
Hand Surgery

Background:

Reconstructing hands with multiple missing digits presents significant challenges.
Toe-to-hand transfer is a viable option for digital reconstruction.
Evaluating simultaneous multiple toe transfers is crucial for optimizing outcomes.

Observation:

This study details the experience with simultaneous transfer of multiple toe units to reconstruct 19 hands in 19 patients.
Forty-six toes from 38 feet were used, with 7 combined second and third toe units and 32 single toes.
Reconstructions included primary and secondary cases, with low failure rates (one complete, one partial).

Findings:

Functional outcomes included two-point discrimination from 6 mm to protective sensation.

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Total active movement averaged 57 degrees in reconstructed thumbs and varied in fingers based on phalanx level.

Pulp-to-pulp pinch strength averaged 2.4 kg (reconstructed thumbs) and 3.0 kg (normal thumbs).

No cold intolerance was reported, and foot function remained largely unaffected.

Implications:

Simultaneous multiple toe transfer is a feasible and safe procedure for complex hand reconstruction.
The technique is both time- and cost-effective, offering a valuable reconstructive option.
This approach can restore significant function and sensation to severely injured hands.