Toe to hand transfer

NewsBot · Jul 24, 2011

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Toe to hand transfer in children: ten year follow up of psychological aspects.
Bellew M, Haworth J, Kay SP.
J Plast Reconstr Aesthet Surg. 2011 Jun;64(6):766-75

Our previous study found positive psychosocial effects from hand reconstruction in children, by microsurgical toe transfer. The aim of the current study was to determine whether these are enduring at ten years or more postoperatively. Twenty-five patients with congenital (n=21) or post-traumatic (n=4) hand anomalies underwent transfer of either one or two toes. (Nineteen of the patients had taken part in the previous study while six had not.) All families had undergone preoperative counselling. Ten years or more after surgery, the patients and their parents underwent review to assess the long-term psychosocial outcome of the surgery. As in the previous study, a high level of satisfaction was reported, in terms of function, appearance, donor site, psychosocial well-being and the reactions of others. This was true regardless of the gender of the child. Patient and parent responses were more similar to each other than they had been in the earlier study. It was concluded that the positive effects of toe transfer surgery are enduring at long-term follow-up.
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NewsBot · Sep 6, 2023

Foot Plantar Pressure Profile Alteration after Microsurgical Great Toe-to-thumb Transfer
Simon Fuk Tan Tang et al
Plast Reconstr Surg Glob Open. 2023 Sep 1;11(9):e5228

Background: Microsurgical great toe-to-thumb transfer (mGTT) is a widely used procedure when immediate replantation of thumb is not feasible. The aim of this study was to investigate the alteration of plantar pressure profile of the donor foot after mGTT.

Methods: Twenty patients receiving microsurgical great toe-to-hand transfer between 1985 to 2014, and 16 healthy subjects were recruited. Group 1 consisted of 20 feet receiving mGTT, whereas group 2 consisted of 32 normal feet as control. The flap design in this study was to preserve 1 cm of the proximal phalanx to maintain the attachment of the plantar aponeurosis and intrinsic muscles. The Taiwan Chinese version of the Foot Function Index was used for patient-reported outcome measurement. A novel Emed-X system was used for dynamic plantar pressure measurement. A total of four parameters were collected, including peak pressure, contact area, contact time, and pressure-time integral.

Results: In group 1, the peak pressure redistributed under the first metatarsal bone and was significantly higher than group 2 (P < 0.05). There was no significant change of the contact area between the midfoot region of group 1 and group 2 (P > 0.05). Furthermore, similar foot clearance efficiency was demonstrated in group 1 and group 2 (P > 0.05).

Conclusions: The windlass effect of the foot will not be affected when performing mGTT with preservation of 1 cm of the proximal phalanx. Therefore, this surgical procedure is highly recommended for clinical application.
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