Free hand-to-toe transfer: a method to minimise donor-site morbidity in free joint transfers

Reconstruction of a congenital hand anomaly in a child using single free vascularised transfer of the proximal interphalangeal joint of a second toe with the simultaneous microvascular reconstruction of the donor toe using the stiff joint and its dorsal skin paddle from the hand is described. This is not the first reported case of a toe–finger switch, but it is the first in a free joint transfer, for which it is especially indicated.