Second toe to index finger transfer

Between April 1994 and May 1998, 15 amputated index fingers were treated based on three classifications: group 1 consisted of patients with index finger defects immediately proximal to, yet including, the distal interphalangeal joint, group 2 were those patients with defects from the proximal part of the distal interphalangeal joint to the distal part of the proximal interphalangeal joint and group 3 comprised patients with more proximal defects than group 2. With a total of six men and nine women, seven cases were included in group 1, five in group 2 and three in group 3. For the patients in groups 1 and 2, only a partial length of the second toe was transferred to the index finger, whereas in group 3 the total length of the toe needed to be transferred. The results can be summarised as follows: 1. The two-point discrimination of the reconstructed index tip was 2.2 mm for group 1, 2 mm for group 2 and 2.3 mm for group 3. 2. In group 1, the average range of motion in the transferred toe was 43.8» in the distal interphalangeal joint. In groups 2 and 3, the average range of motion in the transferred toe was 30» and 30.7» in the distal interphalangeal joint, and 50» and 39.3» in the proximal interphalangeal joint, respectively. 3. When compared with the contralateral index finger, the pinching power was measured at 83% in group 1, 70% in group 2 and 60% in group 3. 4. Excellent results were obtained in group 1, good results in group 2 and fair results in group 3. Accordingly, the more proximal the defect in the index finger, the less satisfactory the result obtained.