title: [Microsurgical 2nd toe transfer for catastrophic hand reconstruction].
abstract: The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1st, 4th and 5th functional fingers. As the essential clamp function between the 1st and 4th or 5th fingers was not totally satisfactory, we decided to reconstruct the 3rd finger of his hand with his ipsilateral 2nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.
authors.affiliation: Servicio de Cirugía Plástica, Reparadora y Estética, Hospital Virgen del Camino, Pamplona, Spain. ainhoaplacer@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Placer
authors.forename: Ja
authors.initials: J
authors.lastname: Lozano
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D004630:Emergencies; D005383:Finger Injuries / Q000209:etiology / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D014034:Toes / Q000637:transplantation*