An amputated thumb causes an estimated loss of 50% of the entire hand's function. A hand without a thumb is, at best, a useful hook.
A partial amputation distal to the metacarpophalangeal joint usually requires nothing more than a well-padded stump which is not adherent to bone and a stump which is free from neuroma (Fig. 1).
An intact thumb may be so adducted by skin and muscle contracture that it is rendered useless. Excision of scar, stripping of the attachment of the adductor pollicis tendon and providing the tendon a more proximal attachment, and the use of a long diamond-shaped pedicle flap, usually give a good result1 (Fig. 2). A thumb amputated near the metacarpophalangeal joint may have so much scar and contracture about the cleft that a useless thumb results. If the amputation is at the metacarpophalangeal joint, a useful thumb can be obtained by deepening the
FLYNN JE, BURDEN CN. Reconstruction of the Thumb. Arch Surg. 1962;85(3):394-398. doi:10.1001/archsurg.1962.01310030042007