Pedicled on-top plasty for thumb reconstruction: utilization of proximal phalanx of an injured ring finger.

Thumb has a critical role in the hand function. It is the most important digit for pinching and grasping. Therefore, thumb amputation demands its replantation or reconstruction to restore the hand functions. A case of hand injury which involved multiple digits along with amputation of thumb is reported. The thumb had amputation level just distal to Metacarpophalangeal joint (MPj) along with amputation of other 3 fingers at different levels. Proximal phalanx of ring finger based on palmar vessels was utilized for on-top plasty to build thumb post and restore hand function. On-top plasty for thumb is quite useful, dependable, easier, time saving option which does not increase the morbidity associated with other options of thumb reconstruction. It may especially be a very useful option for the centres lacking the facility and equipment for micro-vascular surgeries and expertise of the trained micro-vascular surgeons.