Digital reconstruction by free microvascular transfer of two fingers as a unit from the contralateral paralyzed hand

The ideal reconstruction for damaged or missing fingers has yet to be achieved. While toe transfer offers an excellent option for reconstruction of the thumb, this type of reconstruction often falls short in replacement of other digits of the hand. Microsurgical transfer of a finger or fingers from the opposite hand offers an option, but is rarely performed due to the morbidity in the donor hand. The case of a patient with a paralyzed, but otherwise normal, opposite hand presents a unique opportunity to repair the contralateral damaged but innervated hand. This case report deals with such a patient in whom two fingers were moved from a paralyzed hand to replace two traumatically missing digits in his previously normal hand. Technical considerations will be discussed and the result at 33 months will be presented.