The hand is an integral part of the human body with multipurpose utility. Each finger of the hand has its function and assists the hand in performing many activities collectively.
Therefore, challenges faced in performing a routine task in case of a loss of a finger highlight the necessity of having a normal hand with all five fingers intact.
Dr Leena Jain, a leading plastic and hand surgeon, performs toe to hand transfer surgeries. She is available in Mumbai for consultations and treatment. Dr Jain has seven years of experience performing plastic surgeries, limb restorations, and toe-to-hand transfers.
Transfer of a body part from one area to another on the patient. Since the tissue is genetically the same, there are lesser chances of rejection. There could be issues on account of tissue survival and healing.
With the toe to hand transfer procedure, it is possible to remove a toe from the foot and create a new digit in hand. This procedure is feasible as the anatomy of the hand and the foot is quite similar. A microsurgeon or a plastic surgeon with expertise in hand restoration performs this surgical procedure.
Dr Leena Jain, an expert microsurgeon in Mumbai states conditions in which toe to hand surgery is recommended. The toe to hand surgery is recommended in the following conditions -
- Absence of thumb by birth
- Loss of digits on account of burn injuries
- Loss of thumb or other digits on account of accidents and trauma
If the joint of the affected digit has good mobility and the amputation is beyond the finger's middle joint. The likely outcome of this surgery is a good restoration of the functioning of the hand against a short amputation.
Also, in cases with the absence of the thumb and more digits, the hand will require yet another digit to form a tripod pinch.
Pre-surgical considerations for the toe to hand transfer
The treating plastic surgeon will conduct a depth physical examination of the diseased hand and arm. The surgeon will check the condition of the nerves, blood vessels, tendons and ensure their adequate support to the transferred toe.
In case of inadequate condition of nerves, blood vessels, and tendons, the toe transfer is not recommended as the functionality of the toe is affected.
The toe transfer surgery is carried out under general anaesthesia. The toe next to the big toe is usually selected for transplantation as it is considered the most suitable with appropriate tissues, tendons, joints and nails.
The toe is excised from the foot with its associated nerves, blood vessels, bones, and tendons. The gap left behind is closed with sutures and dressed.
The detached toe is then transplanted to the hand and fixed together with a wire (K-wire). The doctor uses an operating microscope to connect the blood vessels and nerves of the toe at the hand. The surgical site is protected with a bulky dressing and plaster during the healing period. It may take about 6-8 weeks to heal completely.
Following the surgery, nurses will regularly check for blood supply to the new finger. The treating surgeon prescribes pain killers to alleviate any discomfort, antibiotics to prevent infection, and blood-thinning medicines to avoid clot formation, which could block the blood vessels.
The patient can return home 5-7 days after the surgery. The dressing to the foot and hand should be maintained clean and dry. The patient will not feel any sensation in the tips of the new digit for the initial months after surgery as the nerve regrowth is slow.
Also, the patient does not have to pinch or grip with a force till the healing of the bone and tendon are not healed completely. The healing process takes at least six to eight months.
Also, the patient will undergo outpatient rehabilitation to improve the motion and control of the swelling.
Complications arising out of a toe to hand transfer surgery
Like all surgical procedures, toe to hand transfer with the following complications:
- Poor blood flow through the repaired vessels could require another surgery
- Slow healing or non-healing
Dr Leena Jain, one of Mumbai’s leading plastic surgeon offer extensive guidance and suitable treatment to reconstruct digits and fingers through toe transfer procedures. Her patients are extremely satisfied with the outcome of the procedures while their hand has gained desired mobility and strength.