The thumb is absolutely critical to overall hand function and quality of life, playing a vital role in both fine manipulation and grasp. Efforts to reconstruct the thumb span the history of hand surgery and represents one of the first microsurgical free tissue transfers to be attempted in humans.
Its importance in ADLs coupled with its complex and intricate anatomy has lead to a host of fascinating reconstructive techniques.
In this article Prof. del Pinal, world renowned pioneer of hand surgery shares his wealth of experience in thumb reconstruction using toe to hand transfer coupled with some novel techniques. Check out the full article in the journal of plastics and reconstructive surgery.

F del Pinal. Extreme Thumb Losses: Reconstructive Strategies. Plast Reconstr Surg. 2019 Sept; 144(3):665-677. doi: 10.1097/PRS.0000000000005983