Aesthetic reconstruction of long fingers with toe-to-hand transfer.

This paper reports experiences of 67 toe-to-hand transfers. Success was achieved in all cases. Six cases are discussed that deal with the less investigated problem of long finger reconstruction. Amputation injuries of long fingers through the metacarpus are difficult problems. A determining principle of their restoration consists of the creation of adequate toe length for transfer and correction of biomechanic hyperextension. The report also highlights the advantages of metacarpal reconstruction with the "brass-knuckle" procedure, as the best technique for this type of injury. Aesthetic and functional advantages after such long finger reconstruction and psychological recovery of the patient seem worthy of emulation.