Salvage of Sensation in a Hallux-to-Thumb Transfer by Nerve Tube Reconstruction

We report a patient in whom, at 3 years after successful reconstruction of a right avulsed thumb with a microvascular hallux transfer, the insensate transfer had sensibility restored. The radial sensory and both volar digital nerves of the thumb were reconstructed using 2.3-mm–diameter bioabsorbable neural conduits. At 30 months after reconstruction, static 2-point discrimination of the hallux was 4 mm at 14.7 g/mm2 in this now 42-year-old right-handed man. The cutaneous pressure threshold for 1-point static touch was 0.7 g/mm2. There were no painful neuromas at the nerve reconstruction sites.