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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 for sewing me back together and guiding me through my recovery!!! - 05/15/18
  • With the severity of my injury I am amazed at how functional my wrist is with the amazing team work shown at the office. From the very start the service and care have been outstanding!! I can't thank everyone enough! - 02/23/18
  • I couldn't be more pleased with the level of service I received while in Dr. Henry's care. The level of detail in which my injury was explained and resolved, and the level of competency that was displayed throughout the healing was truly outstanding. - 01/30/18
  • dr henry does an excellent job of explaining the problem and solution, seems extremely competent - 02/07/18
  • outstanding knowledge and gets you into the hospital if needed the same. - 02/09/18
  • I appreciate the expertise and experience of Dr. Henry!!! I know I had the BEST hand surgeon!!! - 05/02/18
  • The staff is nice and everyone is up on the treatment. I feel confident that I am getting the best care and am glad I came here. - 10/30/17
  • Dr. Henry was able to salvage my hand to make it usable again. I have already sent my Father here and he no longer has any pain in his wrist. - 11/13/17
  • the whole group was very good, I had an excellent experience. - 11/09/17
  • The doctor and staff are the best I have ever had. Very professionalism at its best. - 11/15/17
  • I am really happy with my experience. I always knew what was going on and over time got to know the staff based on how many times I've been here. Most importantly, I feel I got the right treatment for my injury. - 10/19/17
  • Dr. Henry gave me my wrist back!!! Thank you Dr. Henry!!! - 07/10/17
  • no complaints hand is coming along very well - 11/06/17
  • all excellent care - 07/12/17
  • every body was excelent - 01/09/18
  • very helpful. staff was very helpful and outstanding. Dr. Henry explained everything to me - 06/19/18
  • I was very impressed with how I was treated by the doctor as well as the Medical assistant. All my questioned were answered and I was treated with care and respect. Luis was Awesome! Doctor Henry was very informative. I will recommend him to friends and family - 06/09/17
  • an experience beyond expectation - 10/06/17
  • great doctor - 05/23/18
  • thank you - 10/16/17
  • Dr. Mark Henry is a true healer; the finest most competent doctor I've ever encountered. I am forever grateful to Dr. Henry and the entire staff for saving my finger and facilitating my complete recovery with grace and seriousness of intent. Thank you. - 01/10/18
  • Dr. Henry and his staff are phenomenal. Dr. Henry has a gift for not only treating health issues extremely effectively, but he is extremely thorough and very efficient at communication and explaining everything he is doing and all of clearly outlining your options for future procedures. - 05/11/18
  • The staff and the Dr. are very helpful and understanding .I have not yet seen a better staff like this office . I will recommend any one here . - 11/06/17
  • Very efficient practice - 10/19/17
  • every thing was really great - 10/19/17
  • very confortable,Dr. Henrry very professional and very friendly staff - 12/05/17
  • Very happy I came here for the surgery, etc. - 06/09/17
  • :) - 06/01/17
  • Dr. Henry was very informative about the treatment and staff was pleasant. - 01/11/18
  • Outstanding service and results - 10/30/17
  • Dr. Henry is a tremendous doctor! - 05/22/18
  • excellent! dr & staff! - 06/14/17
  • Dr. Henry and his staff are amazing! I was able to get an urgent new patient appointment immediately with surgery that same afternoon. Dr. Henry does an excellent and thorough job explaining my injury and the healing process. Very impressed with his plan of early mobility and physical therapy, which helped restore my function back to normal within 8 weeks of surgery. I would 100% recommend Dr. Henry and his staff! Very pleased and grateful for his help. - 03/23/18
  • you were very good, thank you very much - 05/17/18
  • best place for treatment of hand and wrist problems. Dr. Henry was recommended to me by a friend who is a medical care professional. - 10/06/17
  • Very nice staff and surgeon. Thumb looks good now after surgery, hopefully thumb continues to heal and stays healed. Thank you - 01/30/18
  • The staffs here was GREAT!!!! - 06/21/17
  • Thank you for repairing my injury and being kind in the process. - 01/10/18
  • Great Doctor and staff. Luis is a wonderful asset to the staff - 12/18/17
  • Great job your staff is the best,thank you &GOD Bless all of you! - 06/15/18
  • very good team work, best clinic - 06/21/17
  • MD was very thorough and spent a good amount of time with the patient (me). MD had good bedside manners which you do not see from a lot of doctors nowadays. He also made sure everything was understood and that I was given a chance to ask questions or address any concerns I had. Everyone was courteous and professional. Thank you for making mu visit a pleasant one. - 05/02/18
  • love the circus de sole dvd. everything was amazing. rehab was the best too. - 02/23/18










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