Thumb Reconstruction

Rebuilding a thumb means restoring useful pinch and grasp. Length is only part of the problem. In this episode of Plastics in Practice, we review functional assessment, sensate coverage, and reconstruction choices after thumb tissue loss or amputation. Key takeaways:• Restore useful pinch and grasp. Assess length, stability, motion and sensation alongside the carpometacarpal joint, thenar function, first web space and remaining fingers.• An acute thumb amputation needs urgent specialist replantation assessment. Feasibility, injury pattern and patient priorities guide the decision.• Distinguish coverage needs from missing structural components. Skin coverage alone cannot replace lost bone, tendon, nerve or joint function.• Durable sensate pulp matters. A Moberg flap can cover selected distal palmar defects, but its reach is limited and joint motion must be considered.• Toe transfer and pollicization offer options for selected major losses. Selection depends on the remaining hand, donor effects and the patient’s goals.• Plan for rehabilitation and the tasks that matter to the patient. Thumb length, appearance and survival do not by themselves guarantee useful function. This content is for educational purposes only and is not medical advice. The podcast audio is generated with Google NotebookLM using AI voices. 🎧 Explore this episode:Instagram account: https://www.instagram.com/plasticsinpractice/Apple: https://podcasts.apple.com/us/podcast/thumb-reconstruction/id1835564216?i=1000793038307YouTube: https://youtu.be/zSBh7AqWxDoAmazon: https://music.amazon.com/podcasts/8bef056e-7c87-4224-978e-7e691b04554a/episodes/3a0799b8-467e-4c02-a881-ea1a45079e83/plastics-in-practice-resident-review-thumb-reconstruction📘 Free Study Guide: → https://docs.google.com/document/d/1eiaPHDsg68CBT6XWqKOHD_KtXmBkLPeI/edit?usp=drivesdk&ouid=100306162372447663640&rtpof=true&sd=true #ThumbReconstruction #HandSurgery #Microsurgery #PlasticSurgeryEducation #PlasticsInPractice References:1. British Society for Surgery of the Hand. Revascularisation/Replantation trauma standard. https://www.bssh.ac.uk/_userfiles/pages/files/professionals/Trauma%20standards/6%20Revascularisation%20final.pdf2. Baumeister et al. Functional outcome after the Moberg advancement flap in the thumb. 2002. https://pubmed.ncbi.nlm.nih.gov/11810623/3. Jindal et al. Cadaveric Study of a Z-Plasty Modification to the Moberg Flap for Increased Advancement and Decreased Morbidity. 2016. https://pubmed.ncbi.nlm.nih.gov/26910670/4. Wei et al. Microsurgical thumb reconstruction with toe transfer: selection of various techniques. 1994. https://pubmed.ncbi.nlm.nih.gov/8310027/5. Preisser and Partecke. Comparison of functional results after reconstruction of the thumb. 2003. https://pubmed.ncbi.nlm.nih.gov/12772058/