Abstract
We have performed toe-to-hand transfer on nine pediatric patients with congenital ectrodactyly ( oligodactyly 1 ; monodactyly, 5 ; adactyly, 3 ) since 1994. Mean age at the time of transfer was 4.7 years and the mean follow-up period was 12 years. Seven patients received transfer of the second toe from a normal foot, and the remaining two patients underwent simultaneous amputation of anomalous lower extremities and transfer of the toes from the amputated foot. The toe-to-hand transfers were all successful ; however, all patients required secondary operations. Five patients required surgery for opposing digits. For a patient with a severely ectrodactylous hand, toe-to-hand transfer is an essential procedure, but secondary surgery is required to achieve pinching and grasping function. Additionally, when planning treatment for patients presenting with combined upper and lower extremity abnormalities, reconstruction using “spare parts” should be considered in order to minimize the loss of normal tissue.
