The procedure for lengthening of the first metacarpal in cases of partial loss of the thumb described here utilizes a contiguous skin flap from the hand, reinforced by an iliac-bone graft. It is completed in one operative stage. Its prerequisite is the presence of intact skin along the radial border of the hand.
It is not suggested that this procedure will replace the reconstruction of the thumb by transposition of a neighboring finger, but, if feasible, it is preferable to a method of repair in which an abdominal-skin tube is used. The use of the local hand flap imparts nearly normal sensation and a tactile sense to the new thumb.