Custom-made free vascularized compound toe transfer for traumatic dorsal loss of the thumb

Dorsal compound traumatic thumb loss can be reconstructed in selected young and well-motivated patients with a custom-made partial great toe transfer. The transfer, including the nail complex and vascularized piece of bone, can be fashioned by longitudinally cutting the distal phalanx to approach the appearance of the opposite thumb and to allow for more normal nail appearance. Ten patients illustrate this technique and emphasize its reconstructive potential as well as cosmetic acceptance.