Donor site reconstruction by adjacent half-width metatarsal after full-width metatarsal transfer for metacarpal reconstruction in severe thumb hypoplasia

The treatment of Manske type IIIB and IV thumb hypoplasia remains controversial,and parents increasingly expect to maintain the hypoplastic thumb in preference to a five-digit hand.[1,2]There has been a recent increased number of reports regarding the reconstruction of severe thumb hypoplasia with the use of free metatarsal transfers(MTs).Tsujino et al[3]reconstructed a thumb with a nonvascularized 4th metatarsal,and filled the bone defect with an iliac graft.Chow et al[4]reported on thumb reconstruction with hemi-width MT,which reduced not only the sacrifice of the donor foot but also the strength of the reconstructed metacarpal.