Patient Reported Outcome Measures for Toe-to-Hand Transfer: a Prospective Longitudinal Study

Background: Patient reported outcome measures (PROMs) are an important metric in evaluating treatment efficacy of reconstructive surgery. Toe-to-hand transfer can restore vital prehensile function however this surgery is complex, extensive rehabilitation is required, and there are concerns about donor site morbidity. This study longitudinally explores the benefits of this procedure, from the patients' perspective, using PROMs. Methods: 23 patients who underwent free toe-to-hand transfers from 2012 to 2015 were evaluated pre- and post-operatively using the following validated questionnaires; the Michigan Hand Outcomes Questionnaire (MHQ), the 36-Item Short Form Health Survey (SF-36), and the Lower Limb Outcomes Questionnaire (LFQ). Subgroup analysis was performed between dominant and non-dominant reconstructed hands. Results: Mechanism of injury was crush in 83%; the remainder sustained cutting, avulsions, and burn injuries. 34 toes were transferred; nine great toes, 20 second toes and five third toes. All patients required secondary procedures for aesthetic and/or functional improvement. MHQ results showed significant improvement in overall activities of daily living, work, aesthetics, and patient satisfaction (p

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