Toe-to-Thumb Transplantation — Restoring Grip, Precision & Hand Function with Advanced Microsurgery
Reconstructive Microsurgery at Pratap Hospital, led by Dr. Pratap Duggirala (M.S., M.Ch) offers highly specialized Toe-to-Thumb Transplantation, a gold-standard procedure for patients who have lost their thumb due to trauma, crush injuries, avulsion, or amputation.
As a center known for complex hand reconstruction, microvascular expertise, and limb salvage surgeries in Vijayawada, Pratap Hospital brings world-class surgical precision to restore the most important digit of the hand — the thumb.
With extensive experience in free flap surgeries, arterial/venous repairs, nerve reconstruction, and post-traumatic hand reconstruction, Dr. Pratap performs this procedure with excellence, ensuring restoration of grip, pinch strength, aesthetics, and functional balance.
Toe-to-thumb transplantation provides a lifelike, functional, and long-lasting thumb, enabling patients to return to work, daily activities, and normal hand use.
The thumb contributes to 40–50% of hand function, enabling:
Pinch grip
Power grip
Fine movements
Dexterity
Hand stability
When the thumb is lost due to trauma, reconstruction becomes essential. Toe-to-thumb transplantation (microvascular toe transfer) is the most advanced reconstructive option, where a toe — typically the great toe or second toe — is transplanted to the hand.
This procedure restores:
Lifelike appearance
Excellent motion
Sensation
Strength
Functional independence
It is especially beneficial when local flaps or prosthetic options are not adequate.
✓ Mastery in Microvascular & Reconstructive Surgery
Dr. Pratap has expert-level skills in free flaps, arterial/venous repairs, peripheral nerve surgery, and complex hand reconstruction — essential for successful toe transfers.
✓ High Success Rates with Advanced Techniques
Precision microsurgery ensures reliable vessel connection and long-term viability of the transplanted toe.
✓ Functional & Aesthetic Reconstruction
The new thumb restores:
Pinch/grip
Fine motor skills
Natural appearance
Stability of hand movement
✓ Patient-Friendly, Multidisciplinary Care
Includes orthopedic, physiotherapy, and rehabilitation support to ensure full functional recovery.
✓ Proven Expertise in Post-Traumatic Hand Reconstruction
Ideal for patients with crush injuries, amputations, avulsions, and multi-structure hand trauma.
✔ Detailed Hand Assessment
Condition of amputation site
Skin, bone, tendon, nerve status
Vascular supply
Feasibility of microvascular anastomosis
✔ Foot Evaluation
Toe selection (great toe vs second toe)
Vascular mapping
Expected gait changes
Donor site suitability
✔ Imaging Studies
Doppler/CT angiography for vessel planning
X-rays of hand and foot
✔ Functional Planning Session
Discussing:
Desired thumb length and mobility
Occupational needs
Aesthetic expectations
✔ Preoperative Counseling
Explaining:
Recovery timeline
Rehabilitation requirements
Donor foot adaptation
• Great Toe Transfer
Offers excellent strength
Best for high-demand functional needs
Closer in size to natural thumb
• Second Toe Transfer
More aesthetic match
Less effect on walking
Preferred for balanced hand reconstruction
• Microvascular Anastomosis
Connecting:
Arteries
Veins
Nerves
Tendons
Bones
• Bone Fixation
Using K-wires/plates for stable positioning.
• Tendon Reconstruction
To achieve flexion, extension, and fine movements.
• Nerve Coaptation
For achieving:
Protective sensation
Functional tactile feedback
• Donor Foot Reconstruction
Ensuring minimal gait disturbance.
Step 1: Preparation
Marking vessels, tendons, nerves
Anesthesia and pre-op planning
Two surgical teams work simultaneously (hand & foot)
Step 2: Toe Harvesting
Meticulous dissection
Preserving vessels & nerves
Preparing the toe for transplantation
Step 3: Thumb Reconstruction
Bone fixation
Tendon suturing
Arterial and venous microsurgical anastomosis
Nerve repair for sensation
Skin closure and shaping
Step 4: Post-Operative Care
Monitoring blood flow to the new thumb
Elevation and dressing
Pain management
Step 5: Rehabilitation & Recovery
Physiotherapy for grip & pinch strengthening
Sensory re-education
Regular follow-up
Adaptation for donor foot
Full functional improvement continues over 6–12 months.
1. Which toe is usually used?
The great toe offers best strength; the second toe offers better aesthetics and less gait impact. Choice depends on patient needs.
2. Will walking be affected after toe removal?
Most patients adapt well. The second toe transfer has the least effect on gait.
3. How soon will the new thumb work?
Basic movement begins within weeks; full strength and sensation develop gradually over months.
4. Is this surgery safe?
Yes, when performed by an experienced microvascular surgeon like Dr. Pratap. Success rates are high with proper planning and monitoring.
5. Does the transplanted toe look natural?
Yes. With shaping and long-term adaptation, it resembles a natural thumb in appearance and function.
6. Who is the ideal candidate?
Patients with:
Thumb amputation
Severe crush trauma
Loss of thumb due to infection or burns
Failed previous reconstructions
Book a Consultation
If you’re considering rhinoplasty for aesthetic enhancement or breathing improvement, schedule a consultation at Pratap Hospital today.
Our team will guide you through every step — from evaluation and planning to surgery and recovery — ensuring safe, effective, and natural results.
📍 Pratap Hospital — Reconstructive, Aesthetic & Microsurgery Centre
📞 Call / WhatsApp: +91 94929 69899
📧 Email: drpratapshospital@gmail.com
Before And After Results
