Total thumb reconstruction by an original groin pocket flap-graft design

Background: The thumb plays a key role in hand function for precise dexterity. The surgical treatment of full avulsions of the digital skin sheath by tearing (ring syndrome) is complex and the management of these lesions is challenging for the reconstructive surgeon. When replantation is not possible, other alternatives are available if the covering tissue is thin and flexible. Case presentation: A 30-year-old male, tobacco addict, had a thumbsequelae similar to a stage III ring finger. Revascularization attempt failed and the skin envelope necrosed secondarily. A groin pocket flapgraft allowed a conservation of his thumb with a satisfactory aesthetic and functional result. Conclusions: We described a thumb coverage by a groin flapgraft using an original pocket design. This simple and safe procedure, in the carefully selected patient can successfully address functional and aesthetic concerns simultaneously, with minimal sequelae at the donor site. This technique can be used to treat a cutaneous tearing of the other fingers.