A 2-Stage 6 Toe-to-Hand Transfer for the Reconstruction of Bilateral Digitless Hands

Area of Science:

• Orthopedic Surgery
• Reconstructive Microsurgery
• Burn Reconstruction

Background:

• Metacarpal hand reconstruction presents significant challenges for hand surgeons.
• Severe burn injuries can result in complex hand deformities, impacting function.
• Bilateral metacarpal hand deformities require sophisticated reconstructive strategies.

Purpose of the Study:

• To present a unique case of bilateral Wei Type IIB metacarpal hand reconstruction.
• To evaluate the efficacy of a 2-stage toe-to-hand transfer for restoring hand function.
• To highlight a novel approach using 6 toe transfers for complex bilateral hand reconstruction.

Main Methods:

• A middle-aged female patient with bilateral Wei Type IIB metacarpal hands due to burn injuries was treated.
• A 2-stage surgical reconstruction involving the transfer of the big, second, and third toes to each hand was performed.
• Functional outcomes and donor site morbidity were assessed during long-term follow-up.

Main Results:

• The 2-stage, 6-toe transfer successfully restored tripod pinch function.
• The patient achieved independence in all activities of daily living.
• Minimal donor site morbidity was observed post-surgery.

Conclusions:

• This is the first reported case of a 2-stage, 6-toe transfer for bilateral metacarpal hands.
• The staged approach facilitated a successful reconstruction with reduced surgical morbidity.
• This technique offers a viable option for complex bilateral hand reconstruction after severe burns.