PLEA TO SAVE THE GREAT TOE IN TOTAL THUMB RECONSTRUCTION

Thumb reconstruction remains a controversial field. in young, well-mot ivated patients, in the absence of avulsion injuries, toe to hand tran sfer is an accepted procedure. With refinement, it is possible to avoi d sacrifice of the great toe and in many cases avoid resorting to a se cond toe which is functionally and cosmetically insufficient. Custom-m ade reconstruction allows us both to save the donor great toe and to i mprove function and cosmesis of the donor site. Three basic techniques are reviewed: the modified wrap-around, bipolar lengthening, and twis ted two-toes techniques. (C) 1995 Wiley-Liss, Inc.