A 2-Stage 6 Toe-to-Hand Transfer for the Reconstruction of Bilateral Digitless Hands

Abstract

Reconstruction of metacarpal hands remains a challenging problem for hand surgeons. In this case report, we present a middle-aged female patient with bilateral Wei Type IIB metacarpal hands secondary to severe burn injuries following a motor vehicle accident. The patient underwent a 2-stage reconstruction with big, second, and third toes transfer in each hand to restore tripod pinch. Long-term follow-up demonstrated excellent functional outcomes, with independence with all activities of daily living and minimal donor site morbidity. This is the first report of a 2-stage 6 toe-to-hand transfer in a patient with bilateral metacarpal hands. Approaching this patient’s reconstruction in only 2 stages allowed for a successful outcome with fewer operations and less surgical morbidity.