Reconstruction of mutilating hand injuries by microsurgical free tissue transfers from the foot

•Multiple-toe transfer techniques along with flap coverage options should be considered in mutilating hand injuries.•Three toes from one foot, including the great toe, can be transferred in a single operation.•Crush injuries of the dorsal side of the hand may be reconstructed using combined transfers of bones, joints, tendons, and skin from the foot.•88.7% of patients with mutilating hand injuries were able to return to work after toe transfers.