Thirty-Eight-Year Follow-Up After Multiple Toe-to-Hand Transfers.

Replantation of damaged digits is the preferred treatment for traumatic pediatric hand injuries, but, when replantation is not feasible, second toe-to-hand transfers have been reported since the 1960s as a reconstructive method. This case report discusses a 38-year follow-up of a pediatric patient who underwent bilateral second toe-to-hand transfer after a riding lawn mower accident resulted in traumatic amputations of her right index through little fingers. At follow-up, the patient's hand was assessed for functionality, including range of motion, grip strength, and sensation. The Disabilities of the Arm, Shoulder, and Hand score was 0/100, and 2-point discrimination was 7 mm, indicating high functionality and quality of life. No donor site complications were reported, and the patient actively participated in sports and recreational activities. This case demonstrates that toe-to-hand transplants can restore significant hand function with minimal complications.