Functionally, the thumb is the most important digit. It is different from the fingers and needs special consideration. Anatomically it has one less phalanx, is broader, and is in a different plane, separated from the fingers by a wide first web.
When reconstructing a thumb, it is necessary to:
1. restore adequate length for opposition
2. abduct the thumb so that it can oppose the other digits
3. provide the adduction and flexion necessary for strong pinch and grip
4. provide stability, necessary for effective pinch and grip
5. restore as much mobility (especially of the basal joint) as possible
6. restore as much sensation is possible
7. it is also desirable to insure that it is aesthetically pleasing.
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