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Semin Plast Surg 2022; 36(04): 243-252
DOI: 10.1055/s-0042-1758689
Review Article

Great Toe Transplantation

Antonio J. Forte
1   Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
,
Karla C. Maita
1   Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
,
Ricardo A. Torres-Guzman
1   Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
,
Francisco R. Avila
1   Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
,
Bauback Safa
2   The Buncke Medical Clinic, San Francisco, California
,
Gregory Buncke
2   The Buncke Medical Clinic, San Francisco, California
,
Rudolph Buntic
2   The Buncke Medical Clinic, San Francisco, California
,
Andrew Watt
2   The Buncke Medical Clinic, San Francisco, California
› Author Affiliations Funding None.
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Abstract

Despite being relatively uncommon in the general population, thumb amputations cause severe disability. More than 3,300 thumb amputations occurred in the United States. The thumb makes up around 40% of the function of the hand. Therefore, losing it would result in significant medical, hospital, and societal costs. Thumb reconstruction surgery's primary goal is to restore grip strength, including the range of motion, fine and tripod pinch, power grasp, strength, and sensibility, while secondary goals include restoring hand aesthetics. In cases of thumb replantation, like-for-like replacement is possible; however, when thumb replantation is not possible, great toe-to-hand transplantation is the best available reconstruction. When compared with other reconstructive options such as osteoplastic thumb reconstruction, pollicization, second toe transplantation, and the use of a thumb prosthesis, great toe transplantation provides superior function and aesthetics. For restoring pinch, sensitivity, strength, and aesthetics of the hand with well-tolerated donor site morbidity, toe to thumb transplantation is regarded as the gold standard.

Keywords

vascularized composite allotransplantation - reconstructive surgical procedures - extremities - amputation - thumb - microsurgery


Publication History

Article published online:
21 November 2022

© 2022. Thieme. All rights reserved.

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