Toe transfer surgery – Explained by Dr. Leena Jain from Mumbai

The hand is a versatile tool that is a vital aspect of the human body. Each finger on the hand has a specific purpose and aids the hand in executing a variety of tasks.

As a result, the difficulties encountered when doing a typical task after losing a finger emphasize the importance of having a normal hand with all five fingers intact.

Toe-to-hand transfer procedures are performed by Dr. Leena Jain, Mumbai’s premier plastic and hand surgeon. For seven years, Dr. Jain has been doing plastic operations, limb restorations, and toe-to-hand transfers.

Dr. Leena Jain has 7+ years of expertise as a Hand, Reconstructive Microsurgeon, and Plastic Surgeon.

She was taught by Dr. Samir Kumta, a prominent microsurgeon of international acclaim, after completing her Superspeciality post-graduation at Bangalore Medical College.

She then pursued two microsurgery fellowships on an international level:

  • Hanyang University, Seoul, South Korea, fellowship in microsurgery and perforator flaps.
  • AO Fellowship in Microsurgery and Faciomaxillary Trauma at Ludwig’s Maximillian’s University in Munich, Germany.

A patient’s body part is moved from one location to another. There are fewer possibilities of rejection because the tissue is genetically identical. There may be problems with tissue survival and repair.

It is feasible to remove a toe from the foot and produce a new digit in hand using the toe-to-hand transfer process. Because the hand and foot structure are so similar, this operation is possible. This surgical technique is performed by a microsurgeon or a plastic surgeon with experience in hand restoration.

Dr. Leena Jain, a leading plastic surgeon in Mumbai, explains when toe-to-hand surgery is necessary. In the following cases, toe to hand surgery is recommended:

  • Thumb deficiency from birth.
  • Burn injuries have resulted in the loss of digits.
  • Accidents and trauma result in a thumb or other digit loss.

If the damaged digit’s joint is mobile and the amputation extends beyond the middle joint of the finger. Against a short amputation, this procedure is expected to result in a proper restoration of hand function.

In addition, if the thumb and other fingers are missing, the hand will still require another digit to create a tripod pinch.

Considerations for the toe-to-hand transfer before surgery:

The treating plastic surgeon will thoroughly examine the afflicted hand and arm. The surgeon will examine the nerves, blood vessels, and tendons to ensure that they are in good working order and support the relocated toe.

The toe transfer is not indicated if the nerves, blood vessels, or tendons are poor since the toe’s functionality is compromised.

Procedure

Under general anesthesia, the toe transfer procedure is performed. The toe adjacent to the big toe is frequently chosen for transplantation because it has the most compatible tissues, tendons, joints, and nails.

The toe and its nerves, blood vessels, bones, and tendons are removed from the foot. Sutures are used to fill the space left behind, and the wound is dressed.

The doctor connects the blood vessels and nerves of the toe at hand using an operating microscope. After that, the removed toe is transplanted to the hand and wired together (K-wire). The surgical site is protected with a thick dressing and plaster during the healing process. It may take 6-8 weeks for the wound to heal fully.

After-surgery care

Nurses will check for blood supply to the new finger frequently after surgery. To relieve any discomfort, the treating surgeon provides pain relievers, antibiotics to prevent infection, and blood-thinning medications to prevent clot formation, which could block the blood arteries.

After the surgery, the patient can return home in 5-7 days. The foot and hand dressings should be kept clean and dry at all times. Because nerve recovery is delayed, the patient will have no sensation in the tips of the new digit for the first few months after surgery.

Furthermore, the patient is not required to pinch or grip with force until the bone and tendon have fully healed. The plastic surgeon in Mumbai warns that the recovery procedure will take at least six to eight months.

In addition, the patient will receive outpatient rehabilitation to help with mobility and edema control.

Surgical complications resulting from a toe-to-hand transfer:

Toe to hand transfer, like all surgical treatments, has the following risks:

  • Bleeding
  • Poor blood flow through the reconstructed vessels may necessitate additional surgery.
  • Non-healing or slow healing

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