Strategies in multiple toe transplantation for bilateral type II metacarpal hand reconstruction

Multiple toe transplantation has been established as an effective means of restoring prehensile function in the metacarpal hand. The attainable outcom e, however, must be weighed against potential donor site morbidity. Restora tion of prehensile function in bilateral type II metacarpal hands can be ac hieved by reconstructing three opposable digits in the dominant hand and tw o opposable digits in the nondominant hand. This article outlines the strat egy for optimizing functional outcome and discusses the rationale behind to e selection to reduce donor morbidity.