Salvaging a Failing Toe to Hand Transfer: A Comprehensive Problem-Solving Approach.

Toe-to-hand transfers face various intra-operative and post-operative complications requiring immediate salvage interventions. We present a case of vascularized toe joint transfer complicated by severe vasospasm during papaverine shortage, successfully salvaged using retrograde anastomosis. This experience, combined with literature review, provides a comprehensive framework for managing failing toe transfers including vasospasm, poor donor vessel pressure, arterial thrombosis, and tissue necrosis. Understanding these salvage techniques is essential for any surgeon considering toe-to-hand reconstruction, as prompt recognition and intervention can convert potential failures into successful outcomes.