Limits of indications of the Morrison wrap-around procedure in thumb reconstruction

The thumb contributes approximately 40 percent of hand function. In the case of an amputation, where replantation/revascularisation is impossible, a reconstruction should be planned as the second best treatment. Morrison described in 1980 the technique of a wrap-around partial great toe transfer. According to Morrison, the technique is best suited for reconstruction of the thumb distal to the metacarpophalangeal joint (MCPJ). In this study, we retrospectively report on 10 thumb reconstructions using the wraparound flap from the great toe. Functional results according to the level of amputation are compared. We found in our limited series, that although better results are achieved when the amputation was distal to the MCPJ, the 'wraparound' reconstruction technique still yielded acceptable functional results and outcome in amputation levels through or proximal to the MCP