The reconstruction of a mutilated thumb is one of the most fascinating aspect of hand surgery. The hand deprived of the thumb loses approximately 40 per cent of its function. it corresponds to a total body loss of 22 per cent, which is compatible with the loss of an eye. Recently reconstructive operations were performed for the restoration of the mobility, sensibility, and length of thumb. 4-flap Z-plasty were performed for the skin contracture in the first web space. For the sensibility, we transferred the neurovascular island flap from the middle or ring fingers. And we reconstructed the loss of thumb by pollicization, microsurgical reattachment, and toe-to-thumb transfer operation. We selected 11 cases who were followed over one year after operation.