Bilateral severance of thumbs: report of two cases

Management of hand injuries is a common practice but bilateral amputation of thumbs is very rare. We report on two cases of both thumbs amputated by a similar machine. In case 1, the man's left thumb was closed with a composite skin graft because the severance was through the middle of the nail. A wrap-around procedure was performed to reconstruct the right thumb which was infected after a primary V-Y advancement flap. The final results were acceptable. Replantation of detached thumbs, if possible, achieves the best functional recovery, which was well demonstrated in Case 2. Although the interphalangeal joints were arthrodesed, the patient was greatly satisfied with the results because of excellent appearance, adequate strength and nearly normal sensation. Prevention of bilateral thumb injuries is important. The paper-cutting machine on which these accidents occurred should be improved in order to prevent further similar catastrophes.