Symmetry of vascular pedicle anatomy in the first web space of the foot related to toe harvest: Clinical observations in 85 simultaneous bilateral second-toe transfer patients

Background: Toe-to-hand transfer is an accepted procedure for reconstruction of thumbs and fingers. Although the vascular anatomy of the toe has been well studied, its symmetry on both feet has not previously been reported. Methods: A retrospective review of 85 cases of simultaneous bilateral toe-to-hand transfers, performed between 1984 and 2002, was carried out. All of the pedicles were dissected in a retrograde fashion. Results: A symmetric vascular pedicle anatomy was found in 78.8 percent of the patients, whereas 21.2 percent of the patients had an asymmetric vascular pattern. Conclusions: This result cautions surgeons about the possibility of vascular pedicle asymmetry between two feet in bilateral toe harvest. It proves once more the advantage of a retrograde pedicle dissection technique, which allows for a safe and straightforward toe harvest regardless of the vascular pedicle course variations.