Background <p>Traumatic destruction to the proximal interphalangeal joint (PIPJ) of the fingers is associated with subsequent stiffness and morbidity. An autologous vascularised joint transfer (VJT) from the toe is a beneficial operation to return form and function. The management of the donor site in these cases is underreported. We performed a systematic review of the literature to investigate the different ranges of donor site management. An illustrative case report of a vascularised joint switch technique, both for minimising donor site morbidity and to preserve length of the toe, is also presented.</p> Methods <p>Ovid, MEDLINE, and manual PubMed search of terms ‘vascularised joint transfer’ OR ‘toe to joint’ OR ‘interphalangeal joint transfer’ OR ‘donor site morbidity’ OR ‘joint switch’. Data analysis was performed in Microsoft Excel® (Microsoft, Redmond, WA, USA, version 16.47.1) with quantitative and qualitative statistical methodology where necessary. Fifty-four (54) records were identified. Following screening, 32 studies met our inclusion criteria (261 patients, 292 joints).</p> Results <p>Fourteen studies (44%) do not mention donor site outcomes at all. Eighteen studies (56%) report on donor site outcomes. This results in 153 patients (58.6%) of reported patients in the literature not having outcomes on the donor site described.</p> Conclusions <p>Vascularised joint transfer from toe to a finger is a very useful option for management of the destroyed PIPJ. By exchanging the PIPJ of the toe and finger, donor site morbidity is reduced and provides a potentially excellent outcome in terms of function, length and cosmesis. Donor site morbidity remains underreported. By regularly reporting donor site morbidity, surgeons can be aware of the associated outcomes, which is necessary for patients to make informed choices about their reconstructive options. Level of Evidence: not gradable.</p>