Reconstruction of the Hand with Free Microneurovascular Toe-to-Hand Transfer: Experience with 54 Toe Transfers

Posttraumatic Reconstruction of the Hand—A Retrospective Review of 87 Toe-to-Hand Transfers Compared With an Earlier Report

“…This is demonstrated by the reexploration rate, which dropped from 33% in the 1983 report 7 to 11% in the present study. In addition, ultimate survival rate improved, increasing from 91% to 98%.…”

“…Compared to the previous report, 7 there was an 18% decrease in use of big toe for thumb reconstruction, resulting in a similar increase in use of the second toe. For non-thumb finger reconstructions there was a 60% decrease in use of second and third toe combined, whereas use of the second toe alone increased by the same percentage.…”

“…We interpreted results of toe-to-hand transfers in the last 20-year period in comparison to results of the 1983 report 7 and other series in the literature. Toe-to-hand transfers have become a reliable method for posttraumatic reconstruction of the hand.…”

“…7 In half of the cases, a conventional groin flap was performed, whereas the rest were mainly free flaps. In the previous report, 7 the conventional groin flap was the only flap performed.…”

“…6 The previous experience with toe-to-hand transfers at the senior author's (T.M.T.) institution was published in 1983, 7 in which 54 toe-to-hand transfers over the 6-year period from 1974 to 1980 were reviewed. Although the results published in 1983 were good and similar to other reports at that time, 8 -11 a comparison of the results of toe to hand transfers from 1974 to 1980 and 1981 to 2001 is useful because the first report represents results from the initial period of toe-to-hand transfers.…”