Abstract
In this series the keyword so far as the operation is concerned has been simplicity. A transposed index finger can never be made into a thumb especially in the congenital cases and it may not be wise to strive too hard by means of transplants to emulate the perfection of a normal thumb. You cannot make a silk purse out of a sow's ear but, if sensation, good position and proximal stability are achieved then there can be a useful addition to hand function which is not too distasteful cosmetically.
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