Local Flap Reconstruction for Distal Thumb Amputations: A Case Series

Abstract

Distal thumb amputations result in substantial functional impairment because of the thumb's critical role in grip, pinch and fine motor activities. Local flap reconstruction remains an important option when microsurgical replantation is not feasible. Twelve patients with traumatic distal thumb amputations underwent reconstruction using First Dorsal Metacarpal Artery flaps 5 (41.70%), Moberg flaps 3 (25%), V-Y advancement flaps 3 (25%) and a cross-finger flap 1 (8.30%). The mean age was 29.75 years (range: 16-48 years), and 10 (83.30%) patients were male. All flaps survived completely. Complications occurred in 2 (16.70%) patients and resolved with conservative management. Full range of motion was achieved in 9 (75%) patients, while 3 (25%) had mild restriction. All patients returned to their pre-injury occupations, with a mean return-to-work time of 8.5 weeks. Local flap reconstruction provides reliable soft-tissue coverage, satisfactory functional recovery and low complication rates in distal thumb amputations.