[Thumb replacement by finger exchange and osteoplastic method with island flap plastic surgery after injuries]

In a historical overview, the development of the methods of thumb reconstruction were traced from the simple asensory substitution to the osteoplastic reconstruction with abdominal flaps and bone grafts with and without sensory island pedicle flaps and then to the transposition of a finger as a neurovascular island pedicle flap. The importance of providing normal sensibility is emphasized in order to minimize the loss of thumb function. Fifty-five personal cases of thumb reconstruction by various methods are presented from the Central Institute for Traumatology in Budapest. Clinical examples include the osteoplastic technique with a neurovascular island pedicle flap (Fig. 1), the distraction method of Matev (Fig. 2), and the pollicization of an injured finger (Figs. 3 and 4), as well as an intact finger (Fig. 5). The results are functionally and often esthetically good which has already been shown by Hilgenfeldt.