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Trigger thumbs were found in six members of the same family. Aetiology and treatment is discussed on the basis of the observed and reported anatomy.

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Single stage thumb reconstruction is possible with a new composite skin bone flap from the forearm. The primary vascularisation of skin and bone avoids the disadvantages of the conventional multi-staged procedures such as neurovascular insufficiency, infection and bone absorption. It does not require a surgical team with microsurgical expertise. The best indication is the reconstruction in the subtotal thumb amputation.