AIM :

          Reconstruction of Thumb has remained elusive to plastic surgeons. With various options attempted, explored and performed, thumb reconstruction is still an art to be perfected. In this study we aim to study the reconstruction of thumbs with various local flaps and its functional and aesthetic outcome.

MATERIALS AND METHODS :

          12 patients of single stage thumb reconstruction done in our centre over the period of last 3 years form the study group. All patients who had post traumatic thumb loss, who were not willing for Toe Transfer and who preferred a single stage over a multi–staged procedure were included in the study. Patients underwent various reconstructive options like, FDMA Flap and Neuro–Vascular Island Flap, Posterior interrosseous artery flap and Neuro–Vascular Island Flap, Double Neuro–vascular island flap. Patients underwent bone grafts when required. Follow up period ranged from 3 months to 3 years.

RESULTS :

          All reconstructed patients healed in about 2–3 weeks. All reconstructed thumbs were viable, sensate and functional. More than 60% of patients returned to their original work. Patient felt the reconstructed thumb was aesthetically pleasing except for absence of nail. One patient had marginal flap loss, which was managed.

CONCLUSION :

          Single stage thumb reconstruction using local flaps offers patients an early and nearly comprehensive option for thumb reconstruction. In using the local tissues, the colour and tissue match, along with comparatively minimal donor site morbidity, makes it a good option for patients. Such procedures can be done, even in centres where microsurgical facilities or expertise is less.