الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Thumb is the most important finger in the hand. Every action involving the hand uses the thumb. An opposable thumb makes it easier to do daily tasks including pinching, gripping, grasping, and precision handling.(1)
The purpose of treatment is to restore skeletal stability, cover the thumb in tough, painless skin, and restore appropriate sensory awareness.. Restoration of skeletal stability, the creation of a thick layer of painless skin covering the thumb, and the reestablishment of sufficient sensory perception are all objectives of treatment. (90)
In traumatic thumb loss, emergency replantation should be considered for all thumb amputations proximal to the base of the distal phalanx. If replantation is impossible or fails, several methods of thumb reconstruction may be used.(40)
The extent of injury, condition of the remaining hand tissues, existence or absence of the thenar musculature, age, profession, general health, and functional requirements of the patient all play a role in determining the best strategy for thumb reconstruction..(50)
The level of injury is among selecting the most appropriate technique for thumb reconstruction depends on multiple factors including the level of injury and state of the remaining hand tissues, presence or absence of the thenar musculature, age, occupation, overall health and functional demands of the patient.(105)
Improvements in surgical technique and anatomical knowledge have improved hand soft tissue repair. Flap enhancements brought about by ongoing advancements in design and dissection methods have produced significantly more aesthetically pleasing outcomes for soft tissue reconstruction.(51)
When only a tiny portion of bone is exposed, the V-Y advancement flap offers adequate covering for the distal phalanx tip.(52)
Although the kite flap has become the standard procedure for reconstructing the thumb, there may be other options if the index finger cannot be used as a donor location.The dorsoulnar and dorsoradial branch arteries of the thumb have a consistent and predictable structure, according to numerous anatomical studies. As a result, flaps from the thumb’s metacarpal dorsum area began to form.(15)
Another resurfacing technique uses neurovascular island flaps from the middle and ring fingers in cases of extensive thumb pulp l