Abstract
Despite being relatively uncommon in the general population, thumb amputations cause
severe disability. More than 3,300 thumb amputations occurred in the United States.
The thumb makes up around 40% of the function of the hand. Therefore, losing it would
result in significant medical, hospital, and societal costs. Thumb reconstruction
surgery's primary goal is to restore grip strength, including the range of motion,
fine and tripod pinch, power grasp, strength, and sensibility, while secondary goals
include restoring hand aesthetics. In cases of thumb replantation, like-for-like replacement
is possible; however, when thumb replantation is not possible, great toe-to-hand transplantation
is the best available reconstruction. When compared with other reconstructive options
such as osteoplastic thumb reconstruction, pollicization, second toe transplantation,
and the use of a thumb prosthesis, great toe transplantation provides superior function
and aesthetics. For restoring pinch, sensitivity, strength, and aesthetics of the
hand with well-tolerated donor site morbidity, toe to thumb transplantation is regarded
as the gold standard.
Keywords
vascularized composite allotransplantation - reconstructive surgical procedures -
extremities - amputation - thumb - microsurgery
