Radical resection of a massive venous malformation of the thumb and immediate reconstruction with a microsurgical toe transfer.

A massive venous malformation involving the entire thumb, first web space, and index finger in a young child was treated by radical resection of the venous malformation, including amputation of the thumb distal to the mid-metacarpal and immediate reconstruction with a microsurgical second toe transfer. Five years after surgery, the patient has excellent function of the hand and no evidence of recurrence of the malformation. This case is unique in two respects: first, the venous malformation was of massive size, and second, the unusual venous malformation required total amputation of the thumb and immediate reconstruction with a complete toe transfer.