Thumb reconstruction with an iliac bone graft and a dorsalis pedis flap transplant including the extensor digitorum brevis muscle for restoring opposition: a case report.

A method for thumb reconstruction with an iliac bone graft and a dorsalis pedis flap transplant, including the extensor digitorum brevis muscle for restoring opposition, is presented. This case involved a 21-year-old man with a traumatically absent right thumb at the metacarpal base. Thumb reconstruction by means of an iliac bone graft with immediate transfer of a dorsalis pedis neurovascular sensory free flap, including the extensor digitorum brevis muscle to restore the opponens pollicis muscle, was carried out. After a period of six months he had gained satisfactory opposition of his newly reconstructed thumb to the ring finger, with evidence of contraction of the muscle on electromyograms.