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Toe To Hand Transfer in Children

Part 2: functional and psychological aspects

From the Department of Plastic Surgery, St James’s University Hospital, Leeds, UK

Correspondence: Mr S. P. Kay, Department of Plastic Surgery, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK.

Forty children with congenital (85%) or acquired hand disorders underwent transfer of one or two toes to one hand. The children were reviewed with their parents and assessed for functional and psychosocial performance. There was some evidence that the older the child at the time of transfer, the better the range of motion. The passive range of motion was on average 60° more than the active range of motion despite subsequent procedures such as tenolysis. All transfers recovered protective sensibility and the majority recovered good levels of two point discrimination and light touch perception. Almost all transfers were naturally incorporated into the use pattern of the limb for some or most of the time. Most parents and patients reported a very positive effect of this surgery on the child’s psychosocial functioning.

Journal of Hand Surgery (British and European Volume), Vol. 21, No. 6, 735-745 (1996)
DOI: 10.1016/S0266-7681(96)80177-X


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