Toe transfer in congenital hand malformations

Fifty-eight patients with congenital hand abnormalities underwent 65 toe-to -hand transfers. Symbrachydactyly (51 cases) was the most frequent indicati on. Forty-seven second toe-to-hand transfers were performed in 44 patients. The mean follow-up time was 5.2 years. Two failures occurred in cases in w hich only one artery was anastomosed; no failures were noted when more than one artery fed the transfer. Two patients with a single second-toe transfe r presented with lateral instability of the transferred metatarsophalangeal joint. The mean active range of motion was 38 degrees, with a mean extensi on lag of 25 degrees. The mean two-point discrimination was 5 mm. Forty-one patients used the transferred toe well, when performing activities of dail y living and playing games. Toe-to-hand transfer, prior to the establishmen t of the grip pattern, facilitates integration of the transfer.