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Fig. 9.2. Preparation of the recipient site and extension of the skeleton with an iliac crest bone graft sized and shaped according to the dimensions of the contralateral thumb.

of the stump. A thin full thickness skin graft covers the dorsum and the lateral site of the substantially shortened great toe. With this technique, the need for a cross finger skin flap from the second toe is avoided.

Trimmed great toe offers an alternative solution for thumb reconstruction that avoids the bulk of the whole great toe, and provides the reconstructed thumb with some motion in the IP joint unlike the wraparound. The dissection of the trimmed

Fig. 9.3. Wraparound flap dissected from the ipsilateral great toe, perfused after release of the tourniquet.

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