Reconstruction of the thumb by a free pedal neurovascular flap and composite phalanx-joint-tendon homograft: a preliminary report.

A one-stage procedure for reconstructing the thumb was used in 10 patients, using previously frozen bone-joint-tendon composite allograft and a neurovascular free skin flap from the foot. Levels of injury ranged from the greater multiangular bone to the middle of the first phalanx. Postoperative bony absorption and joint degeneration were minimized, and no cases of tissue rejection were encountered. Further advantages of the procedure are that subsequent nerve regeneration and cutaneous sensibility are improved, and that there are better functional and aesthetic results, compared to other techniques. Using this procedure, donor site dysfunction is also minimal.