Secondary procedures to improve function after toe-to-hand transfers

From August 1990 to December 1992,139 toe-to-hand transfers were performed on 99 patients. Crush, avulsion, and combined crush and avulsion were the mechanisms of injury in 92.8 % of the cases. Average duration of follow-up was 17 months (1 to 40 months). 133 transfers were successful, an overall survival rate of 95.7 %. 19 transfers (14.3 %) required secondary procedures for functional improvement. The incidence of secondary procedure on tendon, bone, joint and soft tissue was 9.0 %, 1.5 %, 2.3 % and 3.0 % respectively. Flexor tenolysis was the single most common secondary procedure (6.8 %). The results of secondary procedures were satisfactory in all but one instance. Transient neurapraxia of an ulnar digital nerve after tenolysis was the only complication of the secondary procedures.