Great toe to hand free tissue transfer.

Thumb reconstruction is a complex subject and the method selected for each patient deserves individual consideration. The method of free toe-to-hand transfer for thumb replacement should be chosen only when the surgeon is familiar with all alternative methods of thumb reconstruction and feels that this technique represents the most reasonable method available. For the surgeon a clear understanding of the anatomic similarities and differences between the normal thumb and great toe are mandatory. In well selected adults and children the failure rate for free toe-to-hand transfer should be very small. The advantages of a single staged thumb replacement from tissue of similar character and quality without local tissue sacrifice are tremendous. With improvement in techniques, experience and case selectiion, much free tissue transfers will actively compete with well established methods of thumb reconstruction. Surely the free toe-to-hand transfer for thumb replacement of today is a forerunner of thumb and hand transplantation of tomorrow.