Overview

• A five-year follow-up study compared 126 toe transfer procedures in 75 patients with 96 replantation surgeries in 52 patients to assess long-term outcomes.
• Toe transfer recipients scored about three times higher on the Michigan Hand Questionnaire than those who underwent digit replantation, exceeding the threshold for clinically meaningful improvement.
• Patients who received toe transfers reported greater gains in physical health on the SF-36 measure and retained foot function comparable to the general population.
• The findings challenge the routine use of emergency replantation as the “gold standard” and position toe transfer as a viable first-line option for certain amputations.
• Investigators highlight a lack of evidence-based guidelines for digit amputation treatment and call for revised clinical protocols to incorporate toe transfer options.