FREE VASCULARIZED TOE TRANSPLANTATION IN RECONSTRUCTIVE SURGERY OF THE HAND

Since the invention of microsurgical techniques the free toe-to-hand t ransplantation is an established method for reconstruction of hand fun ction. The indication for this method following thumb and finger amput ations as well as congenital defects with aplasia of the fingers and t he thumb is discussed in comparism to alternative operations. The oper ative technique as well as the functional and aesthetic results that c an be expected are described by presentation of clinical cases. Since 1992 we performed 18 free toe-to-hand transplantations for the above m entioned indications. Depending on the primary situation the elementar y hand function with grip and pinch could be restored in all our patie nts using this method. Restoring sensibility next to length, mobility and strength in one operation has to be considered as an advantage com pared to alternative methods.