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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  • 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 and Mary in PT helped me get my dominant arm back in working order. - 04/18/17
  • Great Appoitnment - 05/11/17
  • excellent! dr & staff! - 06/14/17
  • thank you - 10/16/17
  • everything HAS BEEN GREAT AND HEALING WELL WITH ALMOST FULL MOTION IN LESS THAN 5 WEEKS. tHANKS dr hENRY - 03/03/17
  • Everyone was kind and efficient. All things were clearly explained to me and I felt confident in doing my dressings. - 03/03/17
  • 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
  • Great work. - 02/03/17
  • joel was also my assistant but everything was great - 03/07/17
  • Dr. Henry gave me my wrist back!!! Thank you Dr. Henry!!! - 07/10/17
  • All the staff and Doctor Henry were great! - 05/01/17
  • 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
  • very helpful staff - 01/16/17
  • I gained full confidence in Dr. Henry and his staff as I progressed through my recovery. - 03/28/17
  • I feel very confident in Dr Henry and the direction I am headed. - 03/10/17
  • Awesome experience. Luis rocks! - 04/06/17
  • :) - 05/11/17
  • everything HAS BEEN GREAT AND HEALING WELL WITH ALMOST FULL MOTION IN LESS THAN 5 WEEKS. tHANKS dr hENRY - 03/03/17
  • FIRST CLASS!!!!!!!!!! - 03/03/17
  • 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
  • This was my last visit and I'll miss y'all. - 03/29/17
  • 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
  • Love the Doctor and his staff. - 02/08/17
  • 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
  • Doctor Henry was awesome! And Luis was very helpful and nice! - 03/20/17
  • Had a wonderful experience overall. Breaking my arm was tough but the staff here was always very, kind and helpful. Especially Dr. Henry, Mary, Karen, Luis, Joel, Teresa and David. I'll miss them all but hopeful won't have to see them any time soon :)Thank you! - 05/04/17
  • Really appreciate the education and insight related to my wrist and future athletic training - 05/31/17
  • Great staff and speedy process! - 04/14/17
  • thank you for helping me - 02/03/17
  • great service nice folks glad I came to this office doctor was very cool - 03/23/17
  • great job! - 03/20/17
  • The staffs here was GREAT!!!! - 06/21/17
  • thank you - 02/09/17
  • Thank you! - 03/08/17
  • 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
  • Great staff. - 05/02/17
  • :) - 06/01/17
  • Very efficient practice - 10/19/17
  • Luis was great as well. - 01/04/17
  • Great Appoitnment - 05/11/17
  • thank you, you all were very helpful - 03/03/17
  • Dr. Henry did an excellent job on my grandmothers wrist. Staff is always very friendly and helpful. - 03/02/17
  • all excellent care - 07/12/17
  • always outstanding service! - 04/12/17
  • 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
  • I have loved coming here and felt very welcomed by everyone! Thank you so much for all you do! - 03/10/17
  • Fabulous I will be recommending to everyone I know that can benefit from the services provided. - 03/14/17
  • Staff was very courteous and helpful. Dr. was very informative and easy to understand. - 03/27/17
  • very impressed with the whole experience. - 02/28/17
  • every thing was really great - 10/19/17
  • Very happy I came here for the surgery, etc. - 06/09/17
  • 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
  • Dr Henry is a wonderful Dr. and I would highly recommend to others - 02/07/17
  • 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
  • very good team work, best clinic - 06/21/17
  • an experience beyond expectation - 10/06/17
  • some of the most friendly staff and the doctor always explained the information in a manner in which I could understand which always made it very helpful. will definitely recommend this location to family and friends. - 05/31/17
  • 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
  • FIRST CLASS!!!!!!!!!! - 03/03/17
  • 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
  • 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
  • Very professional - 03/30/17
  • 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










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