Thumb Reconstruction Using a Twisted Two-Toe Technique

In this study, the authors tried to correlate the function of a new thumb with the aesthetic results of reconstruction in patients in the Plastic and Hand Surgery Service, Centre University Hospital Ostrava, Czech Republic.

Between 1999 and 2004, they treated more than 200 replantations and utilized more than 150 free flaps. Among this number of free flaps, there were 24 toe-to-hand transfers. Twelve patients of this group had a thumb reconstruction: two patients were treated with a second toe-to-hand transfer, two patients were treated with a wrap-around flap and for eight patients, the choice was reconstruction with two twisted toes, according to Foucher and Iglesias.

All flaps survived, except one twisted two-toe case, which failed after five revisions; all of these transfers were functional. There were two cases of delayed healing and one partial necrosis of the second toe.

From an aesthetic point of view, the group of patients who were treated with reconstructions according to Foucher and Iglesias were more satisfied than those with other techniques. This type of reconstruction has been preferred since December 2002.