Primary neurovascular bundle transfer in the management of avulsed thumbs.

During the 5-year period from 1974 to 1979, 23 avulsed thumbs were replanted or revascularized. All procedures were performed by, or directly supervised by, the senior author. Using conventional microsurgical techniques on the first 13 avulsed thumbs, a survival rate of 54% was achieved. To improve survival and to make primary nerve repair possible, primary transfer of the neurovascular bundle from the ulnar side of the long finger was done in the last 10 avulsed thumbs, with a survival rate of 90%.