Radiographic alterations in the foot following toe-to-thumb free transfer

Bone radiographs of 15 males who underwent a toe-hand transplant were studied to characterize alterations in the biomechanics of the foot after the procedure. Anteroposterior, lateral, and sesamoid radiographic views were used. Previous research has assessed this surgery clinically; however, this is one of the first investigations of this technique using conventional radiographs. Definite trends were observed on the operative foot, including stress reaction, disuse osteopenia, arch angle changes, and alignment alterations. Eleven patients exhibited both a stress reaction and some degree of disuse osteopenia. Seven of the subjects demonstrated a decreased arch angle on the operated foot as compared with the contralateral foot. Eight subjects exhibited a varus drift of the second ray. Although these donor defects can be anticipated following this surgery, the long-term benefits of a functional thumb outweigh them.