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Second Toe Transfer

- See:
      - Digit Reimplantation / Reconstruction
      - Thumb Soft Tissue Defects / Amputations

- Indications: selective thumb reconstruction

- Technique:
    - second metatarsal may be removed along with 2nd toe with little functional impairment;
   - toe is taken from contralateral foot to facilitate anastomosis;
   - dorsal triangular flap is planned to be about 4.0 cm in length and 2.0 to 2.5 cm across its base at the toe;
    - apex of the triangle lies directly over the second metatarsal;
    - extensor hallucis brevis is identified;
          - just beneath this muscle, lies dorsalis pedis artery branch;
    - dorsalis pedis continues distally as the first dorsal metatarsal artery;
          - branch of this vessel to the great toe is severed and ligated while that to the second toe is carefully preserved;
    - anastomosis on the hand is usually in anatomic snuff box or the ulnar side of the first metacarpal

Second toe-to-finger transfer in hand mutilations.

Transplantation of the second toe to the hand. A preliminary report of sixteen cases.