From March 1982 to December 1992, 30 cases of thumb reconstruction with a free neurovascular wrap‐around flap from the big toe were performed at Korea University Hospital. Twenty‐nine of a total of 30 cases were successful and obtained excellent functional and cosmetic results. Postoperative complications included 1 case of graft failure, 6 partial skin necroses, 1 malunion, and 15 cases of resorption of iliac bone graft including 1 case of fatigue fracture of grafted bone. Even for the first metacarpal neck amputations, thumb reconstruction with a free neurovascular wrap‐around flap was possible; however, limitation of motion of the reconstructed thumb and resorption of the grafted bone occurred. Thumb reconstruction with a wrap‐around free flap from the big toe gives excellent cosmetic and functional results and causes minimal morbidity on the donor site. © 1995 Wiley‐Liss, Inc.
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