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Secondary procedures to improve function after toe-to-hand transfers

K K Yim1, F C Wei

  • 1Department of Plastic and REconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.

British Journal of Plastic Surgery
|October 1, 1995
PubMed
Summary

Toe-to-hand transfers achieved a 95.7% success rate in 99 patients, with most injuries caused by crush or avulsion. Secondary procedures improved function in 14.3% of cases, with good outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Toe-to-hand transfer is a reconstructive option for severe hand injuries.
  • Understanding outcomes and complications is crucial for patient selection and surgical planning.

Purpose of the Study:

  • To evaluate the success rate and functional outcomes of toe-to-hand transfers.
  • To identify the incidence and types of secondary procedures required.
  • To assess the complication rate associated with secondary interventions.

Main Methods:

  • Retrospective review of 139 toe-to-hand transfers in 99 patients (August 1990 - December 1992).
  • Analysis of injury mechanisms, follow-up duration, transfer survival, and need for secondary procedures.
  • Categorization of secondary procedures by tissue type (tendon, bone, joint, soft tissue) and specific interventions like flexor tenolysis.

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Main Results:

  • Overall transfer survival rate was 95.7% (133 out of 139 transfers).
  • 14.3% of transfers (19 cases) required secondary procedures for functional improvement.
  • Flexor tenolysis was the most common secondary procedure (6.8%), with satisfactory results in all but one case.

Conclusions:

  • Toe-to-hand transfers demonstrate a high success rate for severe hand injuries.
  • Secondary procedures can effectively enhance function after initial transfer.
  • Complications from secondary procedures are infrequent and generally manageable.