Nine patients with irreparable damage to palmar of the thumb, treated with a neurovascular island pedicle flap from the third  or  fourth finger to the defect thumb, have been re–examined 3yrs to  8 years after the operation. Eight patients had a 2–point discrimination of less than 15 mm corresponding to the flap . Two had complete cortical reorientation and three partial reorientation. Six found the function of the thumb to be good or fair. Three described the result as poor and two had to be reoperated because of contractures of the donor finger and/or thumb. The method can be recommended for use in young, well motivated patients