Toe Transfers Outperform Digit Replantation

THURSDAY, Aug. 14, 2025 (HealthDay News) — Toe transfers outperform equivalent digit replantations following digit amputations, according to a study published in the August issue of Plastic and Reconstructive Surgery.

Steven Lo, from the University of Glasgow in Scotland, and Fu Chan Wei, M.D., from Chang Gung Memorial Hospital in Taoyuan, Taiwan, assessed whether toe transfers can match the function of replanted digits following digit amputation. The analysis included 75 patients with 126 toe transfers and 52 patients with 96 digit replantations.

The researchers found that toe transfers showed superior Michigan Hand Outcomes Questionnaire (MHQ) scores (75.7) versus replantation (55.0) exceeding estimates of minimum clinically important differences. These differences increased with increasing severity of injury. Similarly, 36-Item Short Form Health Survey (SF-36) scores for physical health-related quality of life were superior for toe transfers (55.79) versus replantation (53.22). Factors influencing functional scores after toe transfer included moving 2-point discrimination, active range of motion, tripod grip, and SF-36 score, all of which contributed significantly to the MHQ score (r² = 0.55).

“Our study provides the first evidence that toe transfer surgery provides better long-term hand function compared to attempted replantation of the amputated fingers,” Wei said in a statement. “The findings challenge current approaches to emergency replantation surgery after digital amputations.”

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