Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 1:
Great Toe Transplantation
  FIG. 1-35. The intramedullary pin can be removed in 2 weeks.

FIG. 1-36. X ray of a similar transplant in which a transverse screw was used, transfixing all four cortices and producing sound stability, which permits early mobilization.

FIG. 1-37. This patient became captain of his high school football and basketball teams, and was not slowed down by the transfer of his toe to his hand.


Great-toe transplant was performed to a three-fingered hand.

FIG. 1-38. In this instance, the distal end of the metacarpal bone is present with some fibrocartilaginous cover. The metacarpophalangeal joint is to be reconstructed using the articular surface of the base of the large-toe transplant.

FIG. 1-39. Good flexion and extension are present in the residual three fingers of the hand. The palm is somewhat narrowed by loss of the index finger, and pollicization would further cripple this severely injured hand.

FIG. 1-40. The great toe has been successfully transplanted into position. There was vascular compromise on the second day, probably because of a positional change in the extremity during sleep. With the ischemic insult, there was some delay in healing on the ulnar side of the tip of the thumb, but the eventual functional result was not compromised.


FIG.1-41. The patient has fingertip-tactile touch and good grip, and works as a welder without problems.


This patient had a severely injured hand with amputation of the thumb through the distal metacarpal plus injuries to all other fingers.

FIG. 1-42. The functionless, unesthetic index finger and the second metacarpal were removed to increase the first web space. An intramedullary peg between the toe transplant and the remaining metacarpal was fashioned out of part of the discarded index finger.

FIG. 1-43. Strong pinch and grasp have been restored to a severely injured hand.

next page...

  2002 © This page, and all contents, are Copyright by The Buncke Clinic