Thumb reconstruction by the wrap-around method.

Reconstruction of a thumb amputated distal to the metacarpophalangeal joint can be accomplished by the "wrap-around" procedure. The operative procedure calls for an iliac crest graft to replace the bone of the amputated thumb. A flap from the great toe with innervation and circulation intact, including the toenail as well as sensory nerve, is wrapped around an iliac crest graft in a single-stage reconstruction of the thumb. This procedure allows a nice aesthetic result; the nail is transferred, sensibility is restored to the amputated thumb through the transferred neurovascularly intact flap, and the procedure is done at a single sitting. Results to date have been excellent in ten patients.

Duke Scholars

Author James Albert Nunley II Orthopaedic Surgery

Author Richard Douglas Goldner Orthopaedic Surgery

Author James Randolph Urbaniak Orthopaedic Surgery