Toe to Hand Transplantation

Foot-to-hand Finger; Toe to Hand Transplantation Surgery

It is a hand surgery procedure using the microsurgery method to stitch up the hand or toe fingers that are chopped as a result of accidents and traumas. In other words, the microsurgery method is an integral part of hand surgery in such cases. Still, in some cases, it is not possible to stitch up the fingers again. Here, the finger transplant method comes up.

In Which Cases Is Finger Transplantation Performed?

• If the fingers are chopped and cannot be stitched up in time
• In children born with a missing finger
• In case of accidents, if the chopped finger was not carried in the proper shape and condition
• If the hand is injured too badly for transplantation

In these cases, the toes can be transferred to the missing finger area to provide a better aesthetic appearance and functioning during daily activities.

In cases of foot-to-hand finger transplantation, Plastic and Reconstructive Surgeon performs the microsurgery technique. This technique also provides solutions to congenital hand anomalies (excess finger or conjoint fingers), nerve compression of the hand and upper extremity, shape, and functioning disorders due to rheumatoid arthritis and other arthritis and adhesions caused by hand burns. The microsurgery technique is also used to regain lost functions of the organ. For example, if the nerve that moves the fingers of the hand is damaged as a result of the trauma and is not treated, the innerved muscle cannot function. In this case, the muscle taken from another part of the body, along with its nerve is transferred to that region to restore the organ’s function.

Common Foot-to-hand Finger Transplantation Questions

• What are the most common causes of finger loss?
  Occupational accidents are the most significant cause of finger loss. Traffic accidents and losses due to burns are the following causes. Other causes include tumour related conditions and birth anomalies.
• Which finger is transplanted to the hand from foot and where is it transplanted?
  Foot-to-hand finger transplantation procedures are complex and challenging; they are extremely effective in bringing the person back into the business and social life and re-providing hand functions. With this procedure, the big toe is transferred to replace the thumb that is missing in adults. The big toe is more suitable for the thumb in terms of strength and size. In children, the second toe of the foot is often used to create the thumb. Another benefit of transplantation in children is that the transplanted finger has the potential to grow. As the child develops, the transplanted finger develops in terms of function, sensation and size and gains a harmony with other fingers.
• Process of Foot-to-hand finger transplantation surgery
  The primary goal in finger transplantation is the creation of hand thumbs. The next goal of a plastic surgeon is to create the index and middle fingers that will assist in the grip and hold functions of the thumb. The number of the fingers transplanted depends on the hand being dominant or non-dominant or according to the profession of the person. If the patient is using his/her right hand and all fingers of the right hand are chopped, the thumb, index, and middle fingers are formed so that the hand can regain its function. If the less used hand is injured, it may be sufficient to create a thumb and index finger.

Plastic and reconstructive surgeon’s main purpose in all finger transplantation procedures is to ensure that patients can manage daily work and social activities without being dependent on anyone.

Two teams usually engage in long and highly complicated foot-to-hand finger transplantation procedure. The first team prepares the toe to be transplanted using microsurgery methods. At the same time, the other team will get the toes to be transferred; prepare veins, nerves, tendons, and bone. Then the bones and tendons in hand and the transferred finger are detected. Veins and nerves are stitched together using microsurgical methods under a surgical microscope. Sometimes the thumb that is transferred from the foot may be thicker; in this case, thinning procedures can be performed either in the same session or in the following sessions.

• What are the results of the food-to-hand finger transplantation?
  Success rates in food-to-hand finger transplantation have reached up to 95% with today’s technology. The experience of the surgical team is significant here. Also, the severity of the injury and the degree of damage to the tissues and veins are among the factors affecting surgical success. The transplantation has excellent and vital value considering the functions that the patient will regain.
  In some accidents, the person may lose all the fingers of both hands. This awful picture causes a sudden psychological break-down. However, after finger transplantation, most of the patients gain their mobility functions and ability to do their daily tasks on their own. As a result, the person whose fingers chopped regains his/her self-confidence after the transplantation and returns to his/her social life.
• When to perform the toe-to-hand transplantation?
  If the person with a chopped finger is motivated for the operation and the injury is not severe, meaning the tissues are not severely harmed and smashed, transplantation can be done within a few days after the injury. If the transplantation was not done within the first few weeks as called the early period, it can be done later in the future. The important thing at this point is to inform the patient about the issue and to inform about the existence of such a solution. Because there is no time limit for transplantation, for example, for a person who lost his/her fingers many years ago, foot-to-hand finger transplantation may still be the solution today.

The advice of the surgeon to parents is usually as follows:

In case of need for finger transplantation in infants, never waste time. To prevent psychological problems that may occur in children in the advanced ages, consider finger-to-hand finger transplantation without wasting time.

In congenital anomalies, the waiting process before transplantation is one year. If more than one finger needs to be transplanted, the transplantation is completed in one or several sessions in babies after one year old. Surgeons advise parents to have transplantations before the school age to prevent future psychological problems in children.

• What does the patient feel after the toe transplantation?
  We may not be aware of the functions of our hands and fingers in our daily lives. We can understand the difficulties experienced by people who do not have hands and fingers by thinking about the actions we perform with our hands and fingers for 5 minutes. It is incredibly satisfying for these people to know that they will get back the life quality after the surgery.

Of course, sometimes, patients experience problems with tissue healing or physical therapy in the early stages after surgery. Still, the benefits are apparent for people who are under long term follow-up after transplantation.

Toe to Hand Transplantation Frequently Asked Questions

Consultant Plastic, Reconstructive and Aesthetic Surgeon Professor Yazar is available in his private practice based in Nisantasi, Istanbul for appointments to provide detailed and tailored information on the procedure.