The Center for Hand & Upper Extremity Surgery

Toe-to-Finger Transplant

A transplant is a common surgical procedure that involves taking tissue (bone, skin, nerves, etc.) from one area of a patient’s body and transferring it to another area of the body to improve form or function. A toe-to-finger transplant or toe-to-thumb transplant is a unique surgical intervention that restores function to the hand by removing a toe and transplanting it to the hand to replace a missing finger. As with most transplant procedures, this surgery is extremely complex, involving the blood vessels, bones, tendons, and nerves of the toe. However, when performed by an experienced surgeon, a toe-to-finger transplant has a very high success rate and can significantly improve hand form and function by restoring the ability to perform a pinch grip.

Conditions Treated

  • Traumatic finger amputations
  • Congenital finger deficiencies
  • Finger loss due to infection
  • Finger loss due to tumor resection
  • Finger loss due to traumatic injury
  • Coronary revascularization using toe artery
Procedure Time
6-12 Hours
Treatment Location
Hospital
Sedation
General Anesthesia
Recovery Time
3-6 Months

Benefits of a Toe-to-Finger Transplant

A toe-to-finger transfer may help restore or significantly improve hand function after amputation, making everyday activities easier and, in many cases, allowing patients to return to work. While the main goal of this procedure is to improve function, some patients also report increased satisfaction with the appearance of their hands. The defect that is created in the donor’s foot has not been found to produce significant functional alterations.

  • Replace missing digits
  • Improved appearance
  • Restore sensation and movement
  • Regain confidence

 

Are You a Candidate

The eligibility for a toe-to-finger transplant is determined by several factors. Candidates must typically have a significant loss or functional impairment of a finger and be in good overall health. Factors that may disqualify someone from this treatment include severe medical conditions that increase surgical risks, inadequate blood supply to the donor toe, and unrealistic expectations regarding the outcomes of the procedure. Patients should undergo a thorough evaluation by a surgical team to determine their suitability for a toe-to-finger transplant.

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Find Your Surgeon

Our surgical team has distinctive training, skills, and experience in plastic and orthopedic surgeries. This diverse expertise equips them to tackle intricate procedures like toe-to-finger transplants, approaching each case with a holistic understanding of both the functional and aesthetic aspects of the surgery.
Dr. Ajul Shah
Ajul Shah
MD, FACS
Hand and Upper Extremity Surgeon
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Dr. David Tsai
David Tsai
MD
Hand and Upper Extremity Surgeon
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What to Expect

Before

Before undergoing a toe-to-finger transplant procedure, patients will engage in a thorough evaluation process. This phase involves a comprehensive medical assessment to ensure that the patient is an ideal candidate, taking into consideration factors such as overall health, the condition of the missing finger, and the availability of a suitable donor toe. The surgical team will discuss the procedure, potential risks, and expected outcomes with the patient. Additionally, a detailed plan for anesthesia and post-operative care will be established during this stage, and any necessary pre-operative preparations, such as imaging or blood tests, will be conducted to ensure a smooth surgical experience.

During

The actual toe-to-finger transplant procedure is a meticulously orchestrated surgical performance. It typically involves both the recipient and donor sites, requiring the expertise of plastic and orthopedic surgeons. Under general anesthesia, the surgical team harvests the donor toe, skillfully connecting blood vessels, nerves, tendons, and other tissues. Simultaneously, the recipient site undergoes meticulous preparation to receive the transplant. This phase often takes several hours as the surgeons delicately sew together the intricate components. 

The selection of a donor’s toe is dependent on which finger is being replaced. Most commonly, the second toe (the toe next to the big toe) is used for this procedure. In some cases, the big toe may be used.

Ensuring a robust blood supply to the transplanted toe is of paramount importance. The surgery concludes once all connections are secure, and the transplanted toe becomes a functional part of the hand.

After

Following a toe-to-finger transplant, the patient enters a critical phase of post-operative care and rehabilitation. The hand is typically placed in a protective splint or cast to immobilize it and allow the transplanted toe to heal. Some patients may be discharged after one night, while others may stay for a few days or longer, depending on their individual needs and how well they are recovering. 

 

Recovery

Following the initial healing period, rehabilitation is essential to achieve the maximal function of the hand. Light hand activity may begin a few days after the procedure, followed by the gradual integration of therapy exercises and strengthening activities. 

Sensory rehabilitation is also needed once the nerves have healed and the sensation begins to return to the transferred toe (usually 3-6 months after surgery). 

We are proud to work closely with hand therapists to create a comprehensive therapy plan following your surgery. 

 

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Patient Resources

Explore our patient resources to find valuable information, support networks, and post-operative care guidelines to help you navigate your toe-to-finger transplant journey with confidence.

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FAQs

What are the potential risks and complications of a toe-to-finger transplant?
Risks include infection and issues with blood flow. It's essential to discuss these risks with your medical team before the surgery.
How long before I can use my transplanted finger normally?
The timeline for regaining normal use of the finger can vary from several months to a year, depending on individual factors and the success of rehabilitation.
Will the transplanted finger look and function like a natural finger?
While there may be some differences in appearance, with time and therapy, the transplanted finger can look and function quite well, restoring both form and function.
Can I choose not to have a toe-to-finger transplant and use prosthetic options instead?
While toe-to-finger transplants offer a unique solution, prosthetic options are available for those who prefer them. Discuss these choices with your medical team to determine the best approach for your specific situation.
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