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The reconstructed thumb was later used for daily activities, including wearing a lower-limb prosthesis.",{"@graph":14,"@context":65},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/reconstruction-of-an-amputated-thumb-by-great-toe-harvested-from-a-simultaneously-amputated-lower-limb-spare-part-surgery-concept-revisited/408736/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/reconstruction-of-an-amputated-thumb-by-great-toe-harvested-from-a-simultaneously-amputated-lower-limb-spare-part-surgery-concept-revisited/408736.png","ImageObject",300,407,{"name":42,"@type":43},"MrHarris58","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59],{"name":60,"@type":61,"acceptedAnswer":62},"What functional outcome was reported after treatment?","Question",{"text":63,"@type":64},"With follow-up, the patient could use the reconstructed thumb for activities, including pinch and grasp tasks and using a lower-limb prosthesis.","Answer","https://schema.org",{"og:url":32,"og:type":67,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":69,"canonical":32},"index,follow",{"doc_id":71,"site_id":7},408736,1790716745,{"code":4,"msg":74,"data":75},"success",[76,80,84,88,93,98,102,107,111,114,118],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":77,"show_sort_weight":78,"slug":79},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":81,"show_sort_weight":82,"slug":83},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Exam",70,"exam",{"id":89,"doc_module":4,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},5,"Comic",60,"comic",{"id":94,"doc_module":4,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},6,"Technology",50,"technology",{"id":99,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":100,"slug":101},7,40,"healthcare",{"id":103,"doc_module":4,"doc_module_name":25,"category_name":104,"show_sort_weight":105,"slug":106},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},"Religion & Spirituality",20,"religion-spirituality",{"id":109,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":109,"slug":113},"World Cup","world-cup",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":115,"slug":117},10,"Lifestyle","lifestyle",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":89,"slug":121},19,"General","general",{"code":4,"msg":74,"data":123},{"doc_id":71,"user_id":124,"nickname":42,"user_avatar":125,"doc_module":4,"category_id":99,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":131,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":12,"update_tm":135,"read_time":115,"preview_page_count":4},687212988360,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Article published online: 2025-08-06 468 Case Report  \nTHIEME  \nReconstruction of an Amputated Thumb by Great Toe Harvested from a Simultaneously Amputated Lower Limb: Spare Part Surgery Concept Revisited  \nS. Raja Sabapathy 1 Hari Venkatramani 1 Madhu Periasamy 1 Aditya Narasimhan 1 Monusha Mohan 1 Vamseedharan Muthukumar 1  \n1 Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India  \nIndian J Plast Surg 2025;58:468–471.  \nAddress for correspondence S. Raja Sabapathy, MS, MCh (Plastic), DNB (Plastic), FRCS (Edin), Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore 641043, Tamil Nadu, India  \n(e-mail: [rajahand@gmail.com](rajahand@gmail.com)).  \nAbstract  \nKeywords  \n► toe transfer  \n► thumb reconstruction  \n► spare part surgery  \nUtilization of tissues from the amputated part to cover critical structures or enhance function in another area is a valuable technique in reconstructive surgery. For this“spare part surgery” to occur high level of awareness is to be present among surgeons who perform the primary procedure. We are presenting a case wherein the great toe was harvested for thumb reconstruction in a patient who had a nonsalvageable lower limb injury with a crush injury of the hand with amputation of multiplefingers includingthe thumb. The patient on follow-up is using his reconstructed thumb for all his activities including for wearing the lower limb prosthesis. Harvesting the toe from the to be amputated part has the advantages of harvesting more skin, longer length of tendons, vessels, and nerves since there is no need for donor site closure or any concern for donor site morbidity.  \nIntroduction  \nLoss of thumb results in functional loss amounting to 40% of hand function.1 Microvascular toe-to-hand transfer is the gold standard for reconstructing an amputated thumb, typically performed electively. Situations rarely occur where there is an amputation of the lower limb with the same patient requiring thumb reconstruction. We present a case where the great toe was harvested prior to above-knee amputation of a nonsalvageable lower limb and was used to reconstruct the thumb with successful rehabilitation. Increased awareness of the possibility is essential to seize the opportunity of thumb reconstruction sourcing the toe from the limb to be amputated.  \narticle published online August 6, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1810110 . ISSN 0970-0358.  \nCase Report  \nA59-year-old right-handed man sustained crush injuries to his right hand and left lower limb while attempting to board a moving train. He suffered a grade 3B open supracondylar fracture of the femur and a Schatzker type IV fracture of the tibia with skin loss extending from the middle of the thigh to the middle of the leg. Primary management at another center involved debridement and skeletal stabilization of the left lower limb fractures ( ►Fig. 1). The right hand suffered thumb amputation at the metacarpal head level, index finger through the neck of metacarpal, and the middle finger through proximal phalanx ( ►Fig. 2). He reached our hospital 10 days postinjury for soft tissue reconstruction of the lower limb.  \n© 2025 . The Author(s) .  \nThis is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited.([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/))  \nThieme Medical and Scientific Publishers Pvt. Ltd. , A-12, 2nd Floor, Sector 2, Noida-201301 UP, India  \nReconstruction of an Amputated Thumb by Great Toe Sabapathy et al. 469  \nFig. 1 Presenting images of the left lower limb. (A) Nonsalvageable limb with a Mangled Extremity Severity Score (MESS) of 7 and Ganga Hospital Open Injury Severity Score (GHOISS) of 14 .","cbCairTKLcDYJ9Ux","https://ap.wps.com/l/cbCairTKLcDYJ9Ux","pdf",2767653,"English","# Abstract and Keywords\n# Introduction\n# Case Report\n## Injury and initial management\n## Decision for amputation and reconstruction\n## Surgical procedure: great-toe transfer\n## Follow-up and functional recovery","[{\"question\":\"What functional outcome was reported after treatment?\",\"answer\":\"With follow-up, the patient could use the reconstructed thumb for activities, including pinch and grasp tasks and using a lower-limb prosthesis.\"}]","Reconstruction of an Amputated Thumb by Great Toe Harvested from a Simultaneously Amputated Lower Limb: Spare Part Surgery Concept Revisited | PDF",1790580369]