“…First, this type of transfer should be performed only when a well-vascularized hypoplastic rudimentary thumb is available for transfer. Also, the source of blood supply and the arrangement of vessels of the duplicated left thumb were not sufficiently clear prior to the operation, which added some uncertainty and risk to the surgery [8]. Secondly, the skin of the right thumb was damaged over a large area that could not merely be covered by the spared duplicated left thumb, and thus, a donor skin flap was needed.…”