Hand Surgery
Subj: Re: toe to thumb transfer
I heard about this toe to thumb transfer and i
was wandering if you could give me any information or referral.
thanks in advance.
Dr. Bermant responds:
Toe to thumb surgery is designed to reconstruct missing
thumbs from traumatic defects. A toe or parts of a toe are removed
from the foot and the vessels, tendons, and nerves reattached
to the hand. The surgery is not for all defects and there are
several variations depending on the problem. Success depends
on the patients efforts, good hand therapy, and an experienced
surgical team. Rehabilitation takes months and as such is better
managed near where you can stay for the prolonged therapy. Toes
can also be used to rebuild other missing fingers but are rarely
used unless there are multiple missing digits and there is an
opposing thumb.
Yes I perform this surgery.
The American Society of Plastic Surgeons
can be reached by calling 1-800 635-0635. They will send some
preliminary information and a list of board certified surgeons
in your region.
I hope this information proves of some use. If my office
can be of further assistance, please let us know. We can be reached
at: (804) 748-7737.
Michael Bermant, MD
Subj: Re: Born with underdeveloped Hand
The daughter of a friend was born with a partially
developed right hand. She has been told that it may have been
caused by Amniotic Band, or possibly Synbrachydactyly. She is
about 8 months old, and is normal otherwise. What would you suggest
as treatment, or surgery to give her a usable right hand. She
lives in New York and is willing to travel to see specialists.
I am got your E-mail address from the internet. My friend does
not have a computer so I am helping her out. If you wish I can
put you in touch with the parents of this child.
Thank You.
Dr. Bermant responds:
This should not be construed as medical advice. I am a
Board Certified Plastic Surgeon.
There are many forms of "partially deformed hands"
each has different options. Amniotic bands cause constriction
of parts and can impair development of structures. Frequently
a constriction of tissues results requiring a release. Symbrachydactyly
is a transverse absence of parts of the hand. An X-ray can demonstrate
the underlying skeletal deformity and is part of the analysis.
Reconstruction depends on the deformity.
A child has amazing powers of adaptation and frequently
can make what would seem to be an impossible combination of bones
and tissues work. Your best options are for an analysis by a
board certified surgeon who deals with congenital hand deformities.
Good hand therapy is essential with any reconstruction. Although
long distance hand reconstruction is possible, local treatment
has the value of a closer relationship of surgeon and therapist.
The American Society of Plastic Surgeons
can be reached by calling 1-800 635-0635. They will send some
preliminary information and a list of board certified surgeons
in your region. We also see patients who travel for our care.
I hope this information proves of some use. If my office
can be of further assistance, please let us know. We can be reached
at: (804) 748-7737.
Michael Bermant, MD
Subj: Re: information severe hand injury
Dr. Bermant,
I am not exactly sure what kind of surgery your clinic
generally does, however I am writing because I am facing a problem
in relation to hand/arm reconstruction. In 1989, I was involved
in a hunting accident involving a shotgun and a left arm that
happened to be in the wrong place at the wrong time <may as
well make light of it, it is already done :)>. I had numerous
reconstructive surgeries, bone grafts, skin grafts, operations
to reduce the size of the skin graft, removal of pins, etc. I
have experienced no end of discomfort, waking throughout the
night, pins and needles, etc since the operations. I have gotten
to the point that I would much rather have the lower part of
my arm amputated than to bother with this anymore. I used to
be a rather avid hunter, now because of the weakness and pain
in using my left arm this has became a nearly useless venture.
I have done a fair amount of research into prosthetics and have
talked to several prosthetists. I personally believe that I would
be much more satisfied as an amputee than in my current position.
I am in search of a good surgeon in this field.
Please excuse the length of this letter and its rather
rambling nature, but I believe that a time has come to finally
get some answers and solutions to my problems.
Thank you,
Dr. Bermant responds:
This should not be construed as medical advice. I am a
Board Certified Plastic Surgeon.
Yes I work with severe hand injuries. Many patients with
such injuries have difficulties dealing with their situation.
Hand function is not always restorable to preinjury levels. The
pain and loss of use can cause REAL problems. You need to discuss
this with your physicians and therapists. If you have done this
already, do it again. Sometimes psychological therapy offers
some insights.
Your note is not too long nor rambling. Your hand must
really bother you. I hope you can sit down and get some insight
with you doctors, they know your case. If you are looking for
other resources, the American Society of Plastic Surgeons can be reached by calling 1-800 635-0635. They will
send some preliminary information and a list of board certified
surgeons in your region. A good hand surgeon can be either a
plastic surgeon or an orthopedic surgeon. It sounds like you
are frustrated with your condition and not your doctors. If such
go ask for help.
Good luck,
Michael Bermant, MD
Bulletin Board for
Patient's Questions and Answers
Hand 
