The thumb represents at least 40 percent of the function of the hand. If a thumb is lost secondary to trauma, and cannot be replanted, utilization of the great toe or second toe will give the most effective reconstruction. This requires meticulously taking each component of the toe (skin, bone, tendons, vessels, nerves) and repositioning them in the thumb position.
Sometimes, more than 1 digit is required; in that situation several toes may be taken. Surprisingly, loss of the great toe has little impact on the normalcy of walking. A thumb may be created with sensation, flexion and extension, and an aesthetically acceptable result. Dr. Dabb has done this procedure for over 20 years.
Triple Toe-Hand Transfer
This patient lost his hand in an industrial meat grinder. He now writes, plays guitar and neck-reigns his horse.