[Free toe transplantation in reconstructive hand surgery]

Since the invention of microsurgical techniques the free toe-to-hand transplantation is an established method for reconstruction of hand function. The indication for this method following thumb and finger amputations as well as congenital defects with aplasia of the fingers and the thumb is discussed in comparison to alternative operations. The operative technique as well as the functional and aesthetic results that can be expected are described by presentation of clinical cases. Since 1992 we performed 18 free toe-to-hand transplantations for the above mentioned indications. Depending on the primary situation the elementary hand function with grip and pinch could be restored in all our patients using this method. Restoring sensibility next to length, mobility and strength in one operation has to be considered as an advantage compared to alternative methods.