Elective Cross-Hand Transfer With Thumb Transposition: Case Report

An elective case of cross-transfer of the right hand to the left distal forearm stump is reported in a long-standing left radial-carpal amputee who developed a contralateral cerebrovascular accident with severe right-sided spasticity. The thumb column of the right hand was transposed to the ulnar side of the hand as a free flap to improve the appearance of the transferred hand, the tendons were reciprocally repaired, the nerves were connected to permit correct cortical sensory reorientation, and a modified Sauvé-Kapandji procedure was performed to allow for forearm rotation. The functional and cosmetic result was satisfactory for the patient, allowing him to regain independence in activities of daily living.