Four cases of amputation of the entire thumb near or at the metacarpophalangeal joint were successfully treated by a new method designed to retain good sensory innervation. A block of the median nerve allows the surgeon to evaluate the radial innervation to the prospective flap. A three-stage transfer of an abdominal pedicle containing iliac bone is then accomplished and the radially innervated skin flap is used on the hand to provide sensation.