[Substitution of the thumb by transplantation of the second toe]

Authors perform for the substitution of the thumb beside several other operations the transplantation of the second toe. The transplantation is carried out with the reconstruction of the arterial circulation, built on the I. metatarsal artery. Until now 18 substitutions of the thumb were carried out. The etiology of the lack of the toe is variable, in the great majority it is of traumatic origin however purulent process and attempt of suicide occur. With the observation of the rules of structural reconstruction good functional result may be reached. In more than a third of the cases both the sensitivity and the mobility are excellent. The use of this method is suggested first of all in cases where alternative substituting operations are out of question.