Ring finger transfer in reconstruction of transmetacarpal amputations

Four cases are described in which the opposite ring finger was used for finger reconstruction in transmetacarpal hand amputations. Thumb reconstruction was required in three of these four cases. This was achieved by hallux transfer, tube pedicle combined with an innervated first foot web neurovascular free flap, and second toe transfer respectively. In the fourth case, where a thumb was not required, double finger reconstruction was performed by the use of a second toe combined with a ring finger. This case highlights the limitations of the second toe for finger reconstruction, particularly in achieving palmar-digital grip. The advantages of the ring finger are length and mobility, especially sophisticated intrinsic muscle movement, sensory capacity, strength, wider span, and esthetic excellence.