Thumb reconstruction following major loss: a review of treatment alternatives.

Over the past 20 years the available methods for thumb reconstruction following major loss have changed dramatically, primarily through the continued development of microsurgical techniques. Replantation effort is generally indicated when the injury is favorable and the patient can safely undergo emergency and possibly prolonged surgery. Since secondary reconstructions vary markedly with respect to anticipated function and appearance, donor site requirements, and other important factors, the reconstruction method should be individualized according to the patient's age and general health, functional demands, and cosmetic expectations.