Outcomes of multiple microvascular toe transfers for reconstruction in 2 patients with digitless hands: 2- and 4-year follow-up case reports.

Two farmers who sustained amputations of all digits in the dominant hand had hand reconstructions with 3 toes from both feet. Both patients were monitored with hand function tests and validated outcomes questionnaires (Michigan Hand Outcomes Questionnaire and Short Form-36). Long-term follow-up data showed that both patients were able to use the reconstructed hands for activities of daily living and heavy manual farm labor. Until the immunologic problems associated with hand transplantation are solved, multiple toe transfer for total hand reconstruction is a reliable surgical treatment for these patients.