An outcome study of thumb reconstruction using microvascular toe transfer

The purpose of this study was to evaluate outcomes following microvascular toe to thumb transfer in a cohort study using the Michigan Hand Outcomes Qu estionnaire, the 36-item Short-Form Health Survey, the Lower Limb Function Questionnaire, and standardized hand function tests. Twenty-one patients wh o had unilateral, isolated thumb amputations at the metacarpophalangeal joi nts were studied: 16 patients had toe transfer and 5 patients did not have reconstruction. The mean follow-up period was 7.2 years (range, 3-13 years) . Toe transfer patients showed statistically significantly better overall h and function (effect size = 1.4), ADL (effect size = 3.4), work performance (effect size = 2.1), aesthetics (effect size = 1.9), and satisfaction (eff ect size = 1.1). Functional testing showed that strength and dexterity of t he toe transfer hands were comparable to the opposite normal hands. Foot do nor site morbidity was minimal. No significant difference was found in the mean Lower Limb Function Questionnaire scores between the toe transfer pati ents (1.4) and the amputation patients who did not undergo reconstruction ( 1.6). The results of our study showed that patients with toe transfer have better hand function than patients with thumb amputations at the level of t he metacarpophalangeal joints. (J Hand Surg 2000;25A:651-658. Copyright (C) 2000 by the American Society for Surgery of the Hand).