{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T10:00:07Z","timestamp":1778320807696,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>Background: Bilateral metacarpal hand injuries are extremely rare, but probably represent the most difficult reconstructive challenge in hand surgery. Methods: We discuss the various options for metacarpal hand reconstruction, including the Krukenberg procedure, bionic prostheses, multiple toe-to-hand transfers, and possibly hand transplantation, and present the long-term functional outcomes, gait analysis, and psychological evaluation after a 4-stage reconstruction of bilateral metacarpal hands in a child using 6 toe-to-hand transfers\u2014bilateral great toe transfers to reconstruct both thumbs and bilateral combined second-third monobloc transfers to reconstruct 2 fingers in each hand. Results: Reconstruction of bilateral metacarpal hands with 6 toe transfers yielded excellent functional results and patient satisfaction. Conclusions: Bilateral metacarpal hand injuries result in a devastating functional deficit and a major psychological impact. Multiple toe transfers (4, 5, or 6) provide an excellent reconstructive outcome with acceptable donor site morbidity.<\/jats:p>","DOI":"10.1177\/1558944718810844","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T06:53:06Z","timestamp":1542005586000},"page":"465-471","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Bilateral Metacarpal Hands: Reconstruction With 6 Toe Transfers"],"prefix":"10.1177","volume":"15","author":[{"given":"Neil F.","family":"Jones","sequence":"first","affiliation":[{"name":"Shriners Hospital for Children, Los Angeles, CA, USA"},{"name":"University of California, Irvine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Graham","sequence":"additional","affiliation":[{"name":"Shriners Hospital for Children, Los Angeles, CA, USA"},{"name":"University of California, Irvine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Au","sequence":"additional","affiliation":[{"name":"Shriners Hospital for Children, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,11,12]]},"reference":[{"key":"bibr1-1558944718810844","doi-asserted-by":"publisher","DOI":"10.1016\/0072-968X_74_90041-2"},{"key":"bibr2-1558944718810844","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199701000-00019"},{"issue":"1","key":"bibr3-1558944718810844","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0482-5985(07)74560-1","volume":"51","author":"Del Pi\u00f1al F","year":"2007","journal-title":"Rev Esp Cir Ortop 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