Microvascular segmental thumb reconstruction: a case report.

The great toe provides an ideal source of tissue for both functional and aesthetic reconstruction of segmental defects in the thumb and can be used without mutilation of the foot. A successful case is presented of a I-stage primary reconstruction of a segmental defect of the thumb using a composite free flap transfer from the great toe containing pulp, tissue, nail and bone, with neurovascular anastomosis. The donor defect on the great toe was repaired at the same time.