Abstract
The thumb accounts for 40 to 50% of hand function. Reconstruction of soft-tissue contractures include release and coverage with skin grafts or various local, regional, distant, or free flaps. Thumb length, so important for prehension and opposition, can be restored by phalangealization, pollicization, or toe-to-thumb transfer. Secondary techniques such as metacarpal distraction-lengthening or osteoplastic reconstruction are rarely indicated.
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