Thumb Reconstruction eMedicine Orthopedics

Description: The thumb plays an important role in hand function. Daily tasks involving pinch, grip, grasp, and precision handling are more easily accomplished with an opposable thumb. Traumatic loss, congenital absence, or hypoplasia diminishes or eliminates the thumb's prehensile abilities and may affect overall hand function.
Attempts to restore thumb function were recorded as early as 1874, when Huguier reported on the "phalangization" of the thumb metacarpal, which was carried out by deepening the first web space.1 In 1900, Nicoladoni described a reconstruction procedure following traumatic amputation of the thumb in which a staged, pedicled transfer of the great toe was performed.2 Development of microsurgical techniques allowed successful transfer of a toe to a thumb in monkeys in 1965 and in a human in 1966.3, 4
Reports of technical refinements in the toe-to-thumb transfer subsequently appeared in the literature.5, 6 Congenital absence of the thumb from thalidomide exposure provided experience with index finger pollicization for thumb reconstruction.
Synonyms and related keywords: thumb injury, hand injury, toe-to-thumb transfer, toe to thumb transfer, thumb replantation, thumb reconstruction, osteoplastic thumb reconstruction, Moberg flap, Littler neurovascular island flap, kite flap, dorsal metacarpal artery flap, microvascular toe transfer flap, wraparound flap, toe-to-hand transfer, toe to hand transfer, phalangization, pollicization, pouce flottant thumb, Blauth type IV, Blauth type 4, congenitally absent thumb, Blauth type V, Blauth type 5, thumb amputation, toe amputation
Bueno & Wilhelmi 2007