Nine patients had replacement of the thumb and seven, reconstruction of
a finger in a mutilated hand in which the thumb or all fingers had been
amputated. There were twelve successes, three partial successes, and one
failure. A clear knowledge of the anatomy of the dorsalis pedis artery,
avoidance of kinking of the vessels, and adequate precautions against
postoperative edema and venous congestion were essential for success. The
donor foot did not suffer functionally despite the absent second toe.