title: Primary Thumb Reconstruction in a Mutilated Hand.
abstract: The thumb should be preserved at all costs, and major efforts to preserve it are justified. If nothing can be done (or desperate measures fail), classic procedures or a toe-to-hand are indicated. This article will not only discuss some tips to succeed in extreme acute scenarios, but will also consider the indications of other alternatives in the acute or subacute setting.
authors.affiliation: Instituto de Cirugía Plástica y de la Mano, Hospital La Luz, Madrid, Spain; Instituto de Cirugía Plástica y de la Mano, Hospital Mutua Montañesa, Santander, Spain. Electronic address: drpinal@drpinal.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Del Piñal
authors.affiliation: Orthopaedics and Traumatology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Pennazzato
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Esteban
authors.initials: E
authors.lastname: Urrutia
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008488:Medical Illustration; D010781:Photography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation; D013933:Thumb / Q000293:injuries* / Q000601:surgery*; D014034:Toes / Q000637:transplantation
keywords: Ectopic replantation; Mutilating injuries; Partial thumb defects; Toe-to-hand transfer