The surgical repair of amputations of the thumb

Twenty-four thumb mutilations have been repaired by using either whole toe transfers or portions of the big toe for reconstruction. The hallux has many of the properties uniquely suitable for thumb reconstruction. Its total sacrifice, however, leaves a significant defect in the foot, and it is usually too big to look convincing as a thumb. Essential portions of it can be transferred without undue deformity in the foot, and these, in combination with an iliac crest bone graft, can be modelled into a most aesthetic and functional thumb.