[Thumb reconstruction by the second toe transfer with utilization of base of the second or the third metacarpal bones].

Results of grip reconstruction in two patients after severe crush-avulsion injuries of the hand were presented. Total destruction affected the first or the first and the second ray of the hand which was accompanied by soft tissue loss, finger amputations and complex bone fractures with vessels and nerves damage. Soft tissue reconstructions were performed using various methods. Pedicled groin flap followed by nerves reconstruction and tenolysis were done in one patient. In the second case soft tissues were rebuilt with distally pedicled adipo-cutaneous forearm flap supplied by distal radial artery perforators. In both thumb reconstructions the second toe with metatarsophalangeal joint (MTP II) were transferred onto preserved rerouting proximal parts of the second or the third metacarpal bones. In the second patient soft tissue reconstruction and thumb rebuilt were performed during one-stage operation. In both cases complete soft tissue coverage was obtained with restoration of wide and precise pinch grip.