New procedure on making a thumb--one-stage reconstruction with free neurovascular flap and iliac bone graft

A new method for reconstruction of an amputated thumb with a free neurovascular flap and an iliac bone graft in one stage is described. The method consists of four operative steps: (1) preparation of the recipient hand, (2) elevation of a free dorsalis pedis flap, (3) iliac bone graft, and (4) transfer of the flap with microvascular anastomoses. Four successful results with this operation are presented. The method, which reconstructs the thumb in a single operation, is suitable for patients who refuse other reconstructive methods which sacrifice uninjured digits or toes.