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Toe to hand transfer in children. Part 1: technical aspects

S P Kay¹, M Wiberg

¹Department of Plastic Surgery, St James's University Hospital, Leeds, UK.

Journal of Hand Surgery (Edinburgh, Scotland)

|December 1, 1996

Summary

Microvascular toe-to-hand transplantation successfully reconstructed hand deformities in 40 children. While no transfers failed, most required further surgery for optimal function and appearance.

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Area of Science:

Pediatric Surgery
Microsurgery
Hand Reconstruction

Background:

Congenital and acquired hand deformities significantly impact children's quality of life.
Microsurgical techniques offer potential solutions for complex reconstructive challenges.

Purpose of the Study:

To evaluate the technical aspects and outcomes of microvascular toe-to-hand autotransplantation in pediatric patients.
To assess the functional and aesthetic results, as well as the influence on growth, following toe transfers.

Main Methods:

Retrospective analysis of 40 children (9 months–14 years) undergoing toe-to-hand transplantation between 1988 and 1994.
Involved single or double second toe transfers, with detailed follow-up assessments.

Main Results:

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No microvascular transfers failed; all achieved initial viability.
75% of children required staged additional surgeries for functional and aesthetic enhancement.
Hospital stay averaged 9 days, irrespective of the number of toes transferred.

Conclusions:

Microvascular toe transplantation is a viable option for pediatric hand reconstruction.
While successful, secondary procedures are often necessary to optimize functional and cosmetic outcomes.
Further investigation into the long-term effects on growth and development is warranted.