Functional and Surgical Outcomes of Second Toe-to-Thumb Microvascular Reconstruction: A Case Series from a Tertiary Care Hospital in Karachi, Pakistan

Background Traumatic thumb amputations significantly impact daily living and quality of life, and effective reconstructive solutions are needed. This case series evaluated the functional and surgical outcomes of second toe-to-thumb microvascular reconstruction in patients with traumatic thumb amputations, performed at a tertiary care hospital in Karachi, Pakistan. Materials and methods Between 2018 and 2023, five patients underwent second toe-to-thumb transfer, and outcomes were assessed via the Michigan hand outcome questionnaire (MHQ), QuickDASH, and static two-point discrimination. Results All patients achieved satisfactory functional recovery, with QuickDASH scores ranging from 4.5–25 and MHQ scores ranging from 68.3–83.6. Sensory recovery, measured by two-point discrimination ranged from 8 to 10 mm. The study highlights the viability of second toe-to-thumb as a reliable reconstructive option, even in resource limited settings. Moreover, these findings emphasize the importance of early intervention, as patients with shorter delays between injury and reconstruction have better outcomes. Conclusion This case series contributes to the global literature by providing region-specific evidence for thumb reconstruction and underscores the feasibility of complex microvascular procedures in challenging healthcare environments.