Toe-to-hand transfer: an analysis of 14 failed cases.

Fourteen failed cases of 325 patients who had undergone the operation of toe-to-hand transfer to reconstruct the thumb and/or the finger are reported. Five key factors were related to the survival of the transferred toe: two sets of arterial blood supply in the case of an arterial anomaly, the resection of diseased vascular segments, the observation of capillary blood refill for the judgment of circulatory crisis, and the prevention and treatment of a hypercoagulable state.