Our thumbs contribute to everything man-made. Without a thumb, hand function drops to 40% of normal. Three main reconstruction techniques are available to restore this critical part, either missing from birth or from injury. The first one, discussed last week, entails slowly lengthening the thumb remnant. I nickname it begging. This week’s post discusses the second method, which I call borrowing.
Borrowing capitalizes on the fact that the index, middle, ring, and small fingers pretty much do the same thing, and losing one of these digits is not nearly as debilitating as losing a thumb. So, what can be done when the indispensable thumb is missing and four underemployed friends are stationed nearby? Hmm. Borrow one? Yes!
Because of its proximity, the index finger usually gets the call, and its bone can be surgically shortened and rotated to make it thumb-like. The nerves, tendons, and blood vessels blissfully follow along. The surgery, however, is more complicated than remnant lengthening (begging), and it leaves a four-digit hand, which is not bad looking. (Remember: cartoon characters all have four-digit hands.)
The advantages of borrowing for thumb reconstruction include that the new thumb has a nail and that the convalescence is short. The middle finger easily takes over the role of the index finger and can work with the thumb to manipulate buttons, pick up coins and paperclips, and manage a myriad of other common tasks
Next week: Thumb Reconstruction III: Stealing
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