Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis

Introduction Hand amputation at the wrist level is severely disabling, especially when bilateral. It is paramount to restore the hand function to the best possible level for the patient's daily living activities, as well as optimal social and occupational rehabilitation. There are va...

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Main Authors: Rajendra Nehete, Anita Nehete, Amol Ghalme, Abhishek Kulkarni, Al Iqyan Fidvi
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2024-10-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1787870
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author Rajendra Nehete
Anita Nehete
Amol Ghalme
Abhishek Kulkarni
Al Iqyan Fidvi
author_facet Rajendra Nehete
Anita Nehete
Amol Ghalme
Abhishek Kulkarni
Al Iqyan Fidvi
author_sort Rajendra Nehete
collection DOAJ
description Introduction Hand amputation at the wrist level is severely disabling, especially when bilateral. It is paramount to restore the hand function to the best possible level for the patient's daily living activities, as well as optimal social and occupational rehabilitation. There are various options for restoration of function after amputation at wrist and distal forearm levels including Krukenberg's operation, variations of toe transfers, hand allotransplantation, and prosthesis. Krukenberg's procedure and the reconstruction using toe transfer like Vilkki's procedure or two-toe transfers, restore only the pinch. Hand allotransplantation, although it gives excellent function, has limitations due to the complications of immunosuppression. Functional hand prosthesis, though superior in cosmetic appearance, have again limitations in function, and the cost is prohibitive for most patients in our country.
format Article
id doaj-art-a31c60823c1148ca8b73fbacb660e65f
institution Kabale University
issn 0970-0358
1998-376X
language English
publishDate 2024-10-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Indian Journal of Plastic Surgery
spelling doaj-art-a31c60823c1148ca8b73fbacb660e65f2025-08-20T03:38:18ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2024-10-01570534234910.1055/s-0044-1787870Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or ProsthesisRajendra Nehete0https://orcid.org/0000-0001-7891-0889Anita Nehete1Amol Ghalme2Abhishek Kulkarni3Al Iqyan Fidvi4https://orcid.org/0000-0002-3905-1126Division of Plastic Surgery, Vedant Hospital, Nashik, Maharashtra, IndiaDivision of Plastic Surgery, Vedant Hospital, Nashik, Maharashtra, IndiaDivision of Plastic Surgery, Vedant Hospital, Nashik, Maharashtra, IndiaDivision of Plastic Surgery, Vedant Hospital, Nashik, Maharashtra, IndiaDivision of Plastic Surgery, Vedant Hospital, Nashik, Maharashtra, India Introduction Hand amputation at the wrist level is severely disabling, especially when bilateral. It is paramount to restore the hand function to the best possible level for the patient's daily living activities, as well as optimal social and occupational rehabilitation. There are various options for restoration of function after amputation at wrist and distal forearm levels including Krukenberg's operation, variations of toe transfers, hand allotransplantation, and prosthesis. Krukenberg's procedure and the reconstruction using toe transfer like Vilkki's procedure or two-toe transfers, restore only the pinch. Hand allotransplantation, although it gives excellent function, has limitations due to the complications of immunosuppression. Functional hand prosthesis, though superior in cosmetic appearance, have again limitations in function, and the cost is prohibitive for most patients in our country.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1787870toe transfergreat toecombined second and third toebilateral amputationALT flapTDAP flap
spellingShingle Rajendra Nehete
Anita Nehete
Amol Ghalme
Abhishek Kulkarni
Al Iqyan Fidvi
Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis
Indian Journal of Plastic Surgery
toe transfer
great toe
combined second and third toe
bilateral amputation
ALT flap
TDAP flap
title Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis
title_full Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis
title_fullStr Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis
title_full_unstemmed Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis
title_short Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis
title_sort functional restoration of bilateral wrist level hand amputee with six toe transfers and three free flaps an alternative to hand allotransplantation or prosthesis
topic toe transfer
great toe
combined second and third toe
bilateral amputation
ALT flap
TDAP flap
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1787870
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