Toe-to-finger transfer for post-traumatic reconstruction of the fingerless hand

J. S. Williamson, R. T. Manktelow, L. Kelly, A. Marcuzzi, R. C. Mahabir

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Objective: To assess the utility of toe-to-finger transfers (TFTs) for post-traumatic reconstruction of the fingerless hand. Design: A case series. Setting: A regional trauma centre. Patients: Eight men, mean age was 36 years (range from 25-59 yr), who had lost all the fingers from a hand due to a crush-degloving injury (6 patients), frostbite (1 patient) or a burn injury (1 patient). Intervention: TFT. Twelve TFTs were cone and the mean time from injury to reconstruction was 17.2 months. Main outcome measures: Objective (range of motion, moving 2-point discrimination, grip strength, key pinch, Jebsen-Taylor hand assessment, return to work) and subjective (activities of daily living and a questionnaire) measures. Results: Eleven of the 12 transfers survived. Six of the 7 in whom the transfer was successful were available for follow-up (mean 45 mo). Range of motion was 10° at the distal interphalangeal joint, 18° at the proximal interphalangeal joint and 59° at the metacarpophalangeal joint. Sensation was protective in all. Grip strength and key pinch were 26.1% and 70.2% of the contralateral hand respectively. Jebsen-Taylor assessment indicated that basic activities were possible but slowed. All 6 patients returned to work and could perform 92.6% of the activities of daily living unassisted. Hand and foot symptoms were mild. Two-thirds were appearance conscious, 5 of the 6 went on to altered vocations and all reported overall satisfaction as high. Conclusion: This study supports TFT for reconstruction of the fingerless hand in that, although transferred toe function may be poorer than a normal finger, the hand is restored to a useful, sensate and versatile functional unit, such that global hand and patient function, as well as patient satisfaction, are very good.

Original languageEnglish (US)
Pages (from-to)275-283
Number of pages9
JournalCanadian Journal of Surgery
Volume44
Issue number4
StatePublished - Aug 29 2001

ASJC Scopus subject areas

  • Surgery

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    Williamson, J. S., Manktelow, R. T., Kelly, L., Marcuzzi, A., & Mahabir, R. C. (2001). Toe-to-finger transfer for post-traumatic reconstruction of the fingerless hand. Canadian Journal of Surgery, 44(4), 275-283.