Abstract diagram of the important thing findings on this research demonstrating that toe transfers outperform equal digit replantations after amputation. Credit score: Plastic & Reconstructive Surgical procedure (2025). DOI: 10.1097/PRS.0000000000012053
For sufferers with amputations affecting the hand, toe switch surgical procedure gives a substitute for replanting the amputated digits and should result in better enchancment in hand operate and different key outcomes, stories a research in Plastic and Reconstructive Surgical procedure.
“Our study provides the first evidence that toe transfer surgery provides better long-term hand function compared to attempted replantation of the amputated fingers,” feedback Fu-Chan Wei, MD, of Chang Gung Memorial Hospital, Taipei, Taiwan. “The findings challenge current approaches to emergency replantation surgery after digital amputations.”
Toe switch versus finger replantation: New knowledge on patient-reported outcomes
Amputations of the fingers and thumb are widespread accidents, affecting about 45,000 folks per 12 months in america alone. Digit amputations can depart sufferers with years of incapacity, particularly if the thumb is misplaced. Emergency replantation of the amputated digit is the present normal of therapy however is usually inconceivable or unsuccessful.
Toe switch surgical procedure—utilizing a number of of the sufferers’ toes to interchange the amputated digits—is a possible various to replantation. Whereas toe switch surgical procedure isn’t a brand new process, few research have evaluated its influence readily available operate and different patient-reported outcomes.
Dr. Wei and co-author Steven Lo, MD, of Canniesburn Plastic Surgical procedure Unit, Glasgow, Scotland, analyzed long-term outcomes of 126 toe switch procedures in 75 sufferers after digital amputation. Hand operate and different patient-reported outcomes had been in comparison with these of 96 replantation procedures in 52 sufferers. All sufferers had been handled at Dr. Wei’s hospital; outcomes had been assessed at the very least 5 years after surgical procedure.
Information assist toe switch as ‘a viable various’ to replantation
On the validated Michigan Hand Questionnaire, hand operate was considerably higher for sufferers present process toe switch, in comparison with replantation. The distinction in favor of toe switch was substantial, with hand operate scores about thrice larger than the profit thought-about clinically vital. The extra extreme the harm, the better the magnitude of enchancment after toe switch surgical procedure.
Sufferers within the toe switch group additionally had better enchancment in bodily health-related high quality of life, assessed utilizing the usual SF-36 rating. Foot operate after toe switch surgical procedure was similar to that within the normal inhabitants.
The researchers carried out bodily assessments to judge a very powerful components affecting hand operate outcomes. Hand vary of movement, tripod pinch (three-finger grip, as in holding a pencil), and shifting two-point discrimination (a measure of nerve sensation) had been predictors of higher hand operate after toe switch. Greater total bodily and psychological well being scores had been additionally related to improved hand operate.
Earlier research of toe switch surgical procedure have constantly yielded excessive surgical success charges. Nonetheless, these research haven’t included validated assessments of hand operate.
No evidence-based tips have been developed to assist information the choice to carry out toe switch versus tried replantation for sufferers with amputations of the fingers and/or thumbs.
“These data provide the first evidence for the potential functional superiority of toe transfers over replantation in digital amputation using one of the largest validated outcome datasets of toe transfers to date,” Drs. Wei and Lo write.
They imagine their findings problem the idea that emergency replantation ought to at all times be the “gold standard” after digital amputation, and recommend that toe switch will be thought-about “a viable alternative” for some sufferers.
Moreover, this research means that integrating toe transfers into nationwide well being care frameworks has the potential to positively tackle one of many single largest causes of incapacity worldwide.
Extra info:
Steven Lo et al, Toe Transfers Outperform Replantation after Digit Amputations: Outcomes of 126 Toe Transfers, Plastic & Reconstructive Surgical procedure (2025). DOI: 10.1097/PRS.0000000000012053
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Toe switch surgical procedure could enhance outcomes after finger amputation (2025, August 8)
retrieved 8 August 2025
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