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January 7, 1983

Hallux-to-Hand Transfer During Ankle Disarticulation for Multiple Limb Anomalies

JAMA. 1983;249(1):72-73. doi:10.1001/jama.1983.03330250052028

FOR TRAUMATIC loss of the thumb, the techniques and results of hallux transfer for hand reconstruction are well established. In addition, there are several reports of toe-to-hand transfer for reconstruction of the congenitally deficient hand. Most of these cases involved transfer of a normal toe from a normal foot1; in several cases, abnormal toes from cleft feet were transferred.2,3 This case report highlights the treatment of a child who was born with four anomalous limbs. He required an ankle disarticulation because of a severely unstable ankle. During the preoperative planning of amputation, the usefulness of the amputated foot tissues for hand reconstruction was discussed, and a microsurgical hallux-to-hand transfer was performed at the time of ankle disarticulation.

Report of a Case  The patient had four anomalous limbs at birth. No specific etiologic factor could be identified. The left upper limb had syndactylous ring and little fingers; the thumb,