F DEL PIÑAL

From the Institute for Hand and Plastic Surgery, Private Practice, and Mutua Montañesa, Santander, Spain

Journal of Hand Surgery (British and European Volume, 2004) 29B: 2: 120–129

Abstract: Toe-to-hand transfer is widely considered to be unjustified for ‘‘minor’’ finger injuries. In this invited personal view article the indications for toe-to-hand transfer for finger amputation and neurocutaneous and major pulp defects are discussed, and a classification of multidigital injury that has both prognostic and decision-making value is presented. In the author’s opinion a toe transfer should always be considered as an option when reconstructing ‘‘minor’’ finger injuries, as it can reproduce significant long-term benefit to the hand and the patient’s sense of well being. The procedure should be carried out in the acute period, not only because it is technically easier and better for hand function, but above all because the surgeon can save structures that will be lost if the transfer is delayed.