Hand & Wrist Center of Houston Home If you suspect broken bones, dislocated joints, lacerated tendons, lacerated nerves, infection, or have an open wound below the elbow, then call us immediately.
 
TOE TO HAND TRANSFER


WHAT YOU SHOULD KNOW

Severe hand trauma can result in amputation of one or more digits. The most elegant method to reconstruct a missing digit is to use the body part that is the most similar to it, a toe. The second toe, next door to the big toe, is the one most commonly used for reconstruction. There are two indications to consider performing a toe to hand reconstruction. The first is when the amputation is beyond the middle joint of the finger and that joint has good motion. Excellent restoration of digit function can occur in this situation. The other indication is when the hand has lost so many digits that the minimum criteria of two fingers that can form a tripod pinch with the thumb does not exist.

MEDICAL HISTORY

Patients may have already a number of surgeries performed when first appearing in the reconstructive microsurgery clinic. Patients should bring the typed operative reports of these other operations to be reviewed. Important details of the anatomy left behind after the former surgeries are essential in planning the upcoming reconstruction.

EXAMINATION

The location and degree of scar tissue, freedom of joint movement, and level of amputation are closely examined along with all other functions of the affected and the opposite hand.

ADDITIONAL TESTS

If there is any question regarding the anatomy of the blood vessels left behind in the hand, it will be necessary to obtain a picture called an angiogram after injecting dye into vessels using an inserted catheter.

TREATMENT OPTIONS

  SECOND TOE TRANSFER GREAT TRANSFER
CONSISTS OF Whole or partial toe transfer Usually only partial toe transfer or combined parts with some from the second toe
FEATURES All parts needed by the finger are taken from the toe Usually used only in reconstruction of damage to the thumb
ADVANTAGES Can obtain longer transfer by taking bone from the foot level (metatarsal) Better strength, size match better (too large if not trimmed)
DISADVANTAGES For thumb reconstruction is too small and makes a weaker transfer More disturbance of walking ability proportionate to amount of tissue taken in transfer

RECOVERY

The small connections between blood vessels that have been sewn together can clot easily. The patient stays in the hospital for 5 days after surgery for close observation and to receive continuous anticoagulant medication by vein. After hospital discharge, outpatient rehabilitation begins with exercises for motion and control of swelling. The tendon connections must be moved frequently to avoid stiffness. Nerve regrowth is slow and the tips of the new digit do not gain feeling for many months. Forceful gripping and pinching activities are not allowed until after full bone and tendon healing occurs at around 2 months.
 
 
 
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  • thank you, you all were very helpful - 03/03/17
  • Excellent care and service! I would highly recommend Dr Henry and his staff! - 09/14/16
  • great service nice folks glad I came to this office doctor was very cool - 03/23/17
  • Awesome as always! - 10/11/16
  • Excellent treatment by the physician and friendly service by the staff. Will definitely recommend to friends and family. - 09/12/16
  • I was impressed at how fast I was able to get an appointment. The staff was very helpful and the doctor was amazing! - 12/08/16
  • I gained full confidence in Dr. Henry and his staff as I progressed through my recovery. - 03/28/17
  • Amazing people. Luis, Joel and Teresa, and Dr. Henry... I appreciate all of you. Your staff is outstanding. - 09/14/16
  • only wish I would have come here before having surgery done elsewhere. - 11/30/16
  • David, Teresa, Luis, Joel, and Karen have all worked with me. They were all outstanding and I highly recommend them all. - 11/30/16
  • Staff is always friendly and helpful. I will definitely recommend this office. Dr. Henry is a very skilled surgeon and went out of his way to make sure I understood my procedure and the rehabilitation process. - 03/24/17
  • Awesome staff.. - 09/26/16
  • FIRST CLASS!!!!!!!!!! - 03/03/17
  • This was my last visit and I'll miss y'all. - 03/29/17
  • thank you - 02/09/17
  • Dr. Henry did an excellent job on my grandmothers wrist. Staff is always very friendly and helpful. - 03/02/17
  • I have enjoyed this facility and Dr. Henry has been more than helplful. All questions answered, as well as answers I didn't even know I had! The staff is always helpful. - 03/03/17
  • Amazing services and results. Unique experience - 10/31/16
  • We have had the best experience here. The staff has always accommodated us and since Tyler is only 10, they always go out of their way to make sure we are comfortable. I have and will continue to recommend Dr. Henry and his staff to anyone I know. Thanks! - 02/28/17
  • The Doc is awesome and his staff is on their game, the wait can be a little long but you get that when you are dealing with elite care. - 09/19/16
  • Dr. Henry has the best verbal skills I have witness on a physician; and, I have been a physician myself for decades! - 12/01/16
  • Great friendly staff - 10/28/16
  • Luis and all the staff have been great each time I've come in. - 09/22/16
  • Thank you so much for all your support and help! I have benefited a lot from this facility! - 10/13/16
  • everything HAS BEEN GREAT AND HEALING WELL WITH ALMOST FULL MOTION IN LESS THAN 5 WEEKS. tHANKS dr hENRY - 03/03/17
  • At every interaction with your office: consultation with Dr. Henry, day of surgery, need for prescription refills, all follow-up visits, I felt comfortable, welcome, and well informed. On the day of my last visit, I am very optimistic about the function of my left hand. Thank you. - 09/07/16
  • Very knowledgeable about the possible procedures the could be preformed! Dr. Henry is a very honest person and I appreciate that in a man more than anything. He gave me truth and not what I wanted to hear! Thanks - 04/04/17
  • Luis was great as well. - 01/04/17
  • Thank you for the hard work and excellent care. If ever I need this type of care again I will be knocking on your door. I've already recommended your services to others. Thanks Again! - 03/07/17
  • everything HAS BEEN GREAT AND HEALING WELL WITH ALMOST FULL MOTION IN LESS THAN 5 WEEKS. tHANKS dr hENRY - 03/03/17
  • Thank you to everyone here with my surgery and healing process! I really felt comfortable with everyone on the staff and feel as though I came to the best place possible for my surgery. THANK YOU!!!! - 09/09/16
  • thank you for helping me - 02/03/17
  • very impressed with the whole experience. - 02/28/17
  • I have loved coming here and felt very welcomed by everyone! Thank you so much for all you do! - 03/10/17
  • Very pleased with the staff and Dr Henry during my treatment. - 12/15/16
  • great job! - 03/20/17
  • I have enjoyed this facility and Dr. Henry has been more than helplful. All questions answered, as well as answers I didn't even know I had! The staff is always helpful. - 03/03/17
  • Always a pleasure working with Dr. Henry and his awesome staff! - 10/07/16
  • Very professional - 03/30/17
  • The doctor was very informative and provided me with a solution quickly and I really appreciate that in this day and age. This is an awesome institution. - 03/02/17
  • Staff was very courteous and helpful. Dr. was very informative and easy to understand. - 03/27/17
  • Wonderful work no issues - 11/17/16
  • Very pleased with the staff and Dr. Henry. Would highly recommend Dr. Henry to my family and friends in the future. Love this place!!! - 09/07/16
  • Staff exceptional and Dr. Henry is as well. - 11/15/16
  • Thank you! - 03/08/17
  • great - 10/06/16
  • Great staff, Great Doctor, Great surgery, recovery, and follow up. Thank you for the time and attention with helping me through the entire process. I felt very comfortable and safe with the entire process. - 02/10/17
  • Great center with friendly staff and very competent physician. I would definitely recommend to others. - 10/20/16
  • Everyone was kind and efficient. All things were clearly explained to me and I felt confident in doing my dressings. - 03/03/17
  • Great staff and speedy process! - 04/14/17
  • Fabulous I will be recommending to everyone I know that can benefit from the services provided. - 03/14/17
  • I enjoyed my visit - 11/14/16
  • I feel very confident in Dr Henry and the direction I am headed. - 03/10/17
  • I have never doubted I was in the best possible hands here. I cannot correctly express my gratitude. Thank you all very, very much for everything you've done for me. - 11/09/16
  • very helpful staff - 01/16/17
  • very good at explaining how I should take care of my thumbs and always answered any question I had regarding my health issue I was very pleased with my visit and the care I got at both visits - 03/07/17
  • Dr Henry is a wonderful Dr. and I would highly recommend to others - 02/07/17
  • The staff was great. David was very helpful with my surgery scheduling and questions. Luis was fabulous when I needed help with changing my dressing. Joel was nice helping me with the undoing of the dressing. Great group to be a patient of. - 12/13/16
  • Dr. Henry and Mary in PT helped me get my dominant arm back in working order. - 04/18/17
  • ;) - 09/08/16
  • Doctor Henry was awesome! And Luis was very helpful and nice! - 03/20/17
  • I was very pleased with the entire process from first visit to last visit - 09/08/16
  • Very pleased with everyone and the procedures I have had done with Dr. Henry and his staff. - 12/28/16
  • Everyone was great and very helpful. Our family really appreciates the medical attention my son received from his injury. Thank you so much. - 11/01/16
  • Mark is great and so is Luis (I would give Luis a raise!!) - 09/27/16
  • Awesome experience. Luis rocks! - 04/06/17
  • Love the Doctor and his staff. - 02/08/17
  • Amazing Doctor and staff. - 11/16/16
  • I am feeling so much better! My hands do not fall asleep and I do not drop things anymore. Yah! Thank you so much! - 09/16/16
  • Thank you for the help. - 11/10/16
  • FIRST CLASS!!!!!!!!!! - 03/03/17
  • joel was also my assistant but everything was great - 03/07/17
  • Great work. - 02/03/17
  • Dr. Henry and each and every one of the staff we met exhibited a spirit of excellence in every area. From the first visit we were comfortable and confident that we would be well taken care of. - 09/28/16
  • always outstanding service! - 04/12/17
  • This was only a consult, but I felt that I was leaving with enough information and a plan on the next step needing to be taken. - 09/26/16
  • Everyone is always nice - 12/14/16
  • thank you for all you have done! I recommend you foranyone that is having any problems via hand wrist. Amazing surgon and doctor!!! - 02/01/17
  • I will definitely recommend your practice to my friends and family. Thank you very much for seeing me and for the very detailed explanation! - 10/14/16
  • The entire team at the Hand and Wrist Center is outstanding. They made the recovery so smooth and comforting from the courteous receptionists, excellent occupational therapist, attentive medical assistants, and brilliant doctor. Thank you! - 03/31/17
  • Luis was very kind and helpful with all of my questions and concerns. He also assisted me with obtaining supplies for my brace and hand until I can get to therapy. - 10/21/16
  • Great detailed information. - 11/03/16
  • Everyone here has been awesome. We appreciate everything you all have done. thank you! - 12/05/16










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