Reconstruction of the thumb takes precedence over the other digits since it accounts for over forty percent of hand function. In a mangled hand, it is imperative to choose what can be saved and what could be used as reconstruction parts for other digits.

We share our experience with successful reconstruction of the thumb by heterotopic reimplantation of the ring finger.

We present a case of a 45-year-old male known smoker who sustained a machine grind injury at the workplace leading to amputation of the thumb, index and ring fingers and extensive soft tissue loss to the middle fingers. Assessment of the amputated parts revealed the thumb and index finger to be unsalvageable. A decision was therefore made to reconstruct the thumb with the amputated ring finger and repair the extensively damaged middle and little finger.

Post-operatively, the patient was able to have good sensory recovery and pinch grip.