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Toe to Hand Transplantation: 14 Years of Brazilian Experience with 30 Consecutive Cases
Hsiang Wei Teng, MD; Rames Mattar Jr, MD; Marcelo Rosa de Rezende, MD; Luciano Ruiz Torres, MD
Orthopedic Surgery, University of Sao Paulo, Sao Paulo, Brazil

We operated on consecutively from 1996 to 2010 thirty patients with hand pinch deficiency, using toe to hand transfer technique, described by Cobbett in 1968 and later modified by Morrison. The mean age was 22 years old. The main cause of pinch loss was traumatic amputation of the thumb. 87% of the transferred toe were the second. There was only one failure (3.3%), which was treated successfully by redoing the transfer from another foot. The very special case was a transfer of big toe of one foot for thumb reconstruction combined with a second toe of another foot for index ray reconstruction of the same hand, at the same operating session. We conclude this technique is very reliable, with excellent functional results. However, the knowledge of detailed donor site anatomy and its variation is essential, as well as adequate skin coverage of the recipient site.



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