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The Foot as Donor Site for Functional Unit Reconstruction in the Hand with Toe Transfer Variations.

Harvey Chim¹, Lin Feng Liu², Dong Chul Lee³

¹From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Louisiana State University Health School of Medicine.

Plastic and Reconstructive Surgery

|March 26, 2025

Summary

Toe transfers offer versatile solutions for hand reconstruction, preserving foot function. This study details various toe transfer techniques for diverse hand defects, emphasizing functional and aesthetic restoration.

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Area of Science:

Orthopedic Surgery
Plastic Surgery
Reconstructive Surgery

Background:

The foot serves as an excellent donor site for hand reconstruction.
Standard toe transfers (great or second toe) are common, but variations exist.
Preserving all ten toes is a key consideration in reconstructive procedures.

Purpose of the Study:

To illustrate the application of diverse toe transfer variants for hand defect reconstruction.
To address functional and aesthetic requirements in hand reconstruction using toe grafts.
To present a comprehensive overview of toe transfer techniques for various hand injuries.

Main Methods:

Review and presentation of clinical cases involving toe transfers for hand reconstruction.
Detailed description of different toe transfer variants tailored to specific defect types.
Focus on preserving the integrity and function of the foot's digits.

Main Results:

Successful reconstruction of various hand defects including pulp, nail complex, and joint defects.
Effective restoration of function and aesthetics in cases of complete finger amputations.
Demonstration of toe transfers for rarer indications like vascularized toe joint transfers.

Conclusions:

Toe transfers are a highly adaptable method for reconstructing a wide spectrum of hand defects.
Tailored toe transfer variants can achieve excellent functional and aesthetic outcomes in hand surgery.
Preservation of foot function and digit count is achievable with meticulous surgical planning.