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Evolution and Innovation in Toe-to-Hand Transfers.

Yu-Te Lin1,2,3, Fu-Chen Wei1,2,3

  • 1Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

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Summary

Microsurgical toe-to-hand transfers offer excellent functional and aesthetic outcomes for thumb and finger reconstruction. Techniques developed over four decades minimize donor site morbidity, enhancing patient results.

Keywords:
combined second and third toe transfersmetacarpal handthumb reconstructiontoe transfers

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Area of Science:

  • Microsurgery
  • Orthopedic Surgery
  • Plastic Surgery

Background:

  • Microsurgical toe-to-hand transfer has been a reconstructive option since the late 1960s.
  • Global advancements have established it as a reliable procedure with good functional and aesthetic outcomes.
  • Donor site morbidity is an important consideration in toe-to-hand transfers.

Purpose of the Study:

  • To review significant concepts, surgical skills, and reconstruction strategies for toe-to-hand transfers.
  • To highlight advancements developed at Chang Gung Memorial Hospital over four decades.
  • To emphasize factors crucial for successful toe-to-hand reconstruction.

Main Methods:

  • Review of surgical techniques and outcomes in toe-to-hand transfers.
  • Analysis of strategies for thumb and finger reconstruction.
  • Discussion of methods to minimize donor site morbidity.

Main Results:

  • Key factors for successful reconstruction include avoiding stump shortening and ensuring adequate coverage.
  • Retrograde vascular pedicle dissection aids in safe and quick toe harvesting.
  • Modified great toe, lesser toe wrap-around flaps, and combined toe transfers enable optimal reconstruction for complex cases.

Conclusions:

  • Preserving bone and including a foot skin flap minimizes donor site morbidity.
  • Specific techniques allow for optimal thumb and finger reconstruction even in challenging cases.
  • Continued refinement of techniques improves functional and aesthetic results in toe-to-hand transfers.