Restoration of functional prehension after radial hemihand amputation in a three-year-old child: rationale for and long-term result after great toe transfer.

Abstract

Partial hand amputations are rare injuries among children, causing significant functional impairment. Reports on thumb reconstruction in children and adults are used to develop a reconstruction plan for restoring prehension. While either first or second toe transplantation may be indicated to restore prehension in adults with thumb loss, near universal reluctance to use the great toe in children centers around concern regarding the subsequent function and appearance of the foot. This report details the reconstruction of functional prehension after radial hemihand amputation in a 3-year-old child. Great toe transplantation was used and resulted in neither objective nor subjective donor site morbidity. The rationale for use of the great toe in this child and long-term functional outcome are described.