Concomitant Starfish Procedure and Thumb On-Top-Plasty: Surgical Technique and a Report of 2 Cases.

Two patients, a 65-year-old male and a 61-year-old female, presented with 5-digit partial hand amputations following pressor-induced necrosis and an industrial accident, respectively. Both patients had thumb metacarpophalangeal disarticulations with healthy interossei. These patients underwent combined Starfish procedures and thumb on-top-plasty utilizing the necessarily resected distal index metacarpals. Both patients went on to bony union, functional opposition, and use of their myoelectric prostheses. For patients with 5-digit partial hand amputations, the use of the resected distal 3 cm of index metacarpal to lengthen the remnant thumb can be done safely while performing a Starfish reconstruction.