Thumb Reconstruction With a Superficial Palmar Branch of the Radial Artery Flap–Augmented Wrap-around Flap

The thumb is important for hand function; therefore, functional reconstruction after amputation is necessary. Traditional methods, such as wrap-around flap (WAF) and twisted WAF, often involve extensive tissue harvest from the toes. This report introduced a novel approach using a WAF augmented with a superficial palmar branch of the radial artery (SPBRA) flap, which enabled effective reconstruction with reduced donor-site morbidity. A 31-year-old man sustained a traumatic thumb amputation during a cattle-handling accident. Emergency replantation was unfeasible due to severe vascular avulsion. Preoperative computed tomography angiography identified a proximally branching SPBRA, enabling reconstruction using the SPBRA flap-augmented WAF technique. This method allowed effective thumb reconstruction while reducing donor-site complications. The SPBRA flap was harvested 4.9 cm proximal to the radial styloid, enabling primary donor-site closure without additional toe tissue harvest. Although not suitable for all cases, this approach optimizes functional and aesthetic outcomes, offering a less invasive alternative for thumb reconstruction.