Microvascular Toe-to-thumb Transfer After High-voltage Electrical Burn: A Case Series and a Narrative Review

Area of Science:

• Microsurgery
• Reconstructive surgery
• Electrical injury management

Background:

• High-voltage electrical injuries pose unique challenges for thumb reconstruction due to unpredictable vessel damage.
• Determining the extent of injury and optimal timing for reconstruction remains difficult.
• Toe-to-thumb transfer is a reconstructive option for thumb amputation.

Purpose of the Study:

• To present successful cases of microsurgical thumb reconstruction following electrical amputation.
• To evaluate the functional outcomes and donor-site morbidity of toe-to-thumb transfer in electrical injury cases.

Main Methods:

• Retrospective review of a single surgeon's experience.
• Analysis of 3 free toe-to-thumb transfers in 2 patients with electrical thumb amputation.
• Assessment of functional recovery (sensibility, motion, pinch strength) and donor-site outcomes.

Main Results:

• All 3 toe-to-thumb transfers resulted in successful thumb reconstruction.
• Patients regained functional sensibility, motion, and adequate pinch strength for daily activities.
• Minimal morbidity was observed at the toe donor sites.

Conclusions:

• Microsurgical toe-to-thumb transfer is a successful reconstructive strategy for thumb amputation caused by electrical injury.
• This technique can achieve good functional outcomes despite extensive soft-tissue damage.
• Reconstruction should be considered even in complex cases of electrical thumb amputation.