The Foot as Donor Site for Functional Unit Reconstruction in the Hand with Toe Transfer Variations

The foot is an ideal donor site for reconstruction of defects in the hand. Although standard toe transfer variants such as great or second toe transfer are commonly used, other variants can be designed, depending on the requirements of the defect. In this article, the authors illustrate the use of toe transfer variants to reconstruct different defects in the hand following functional and aesthetic units. Where possible, all 10 toes should be preserved. Specifically, we discuss reconstruction of pulp defects, nail complex defects, proximal interphalangeal joint defects, web space defects, complete finger amputations and rarer indications for vascularized toe joint transfers. Cases from all authors are presented.