Since 1985, 76 pedicled island flaps had been used for primary repair of skin defect of thumb and 62 flaps for reconstruction of thumb. Fifteen thumbs were reconstructed by 29 pedicled island flaps in which 14 from dorsum of middle phalanx of index and middle fingers, 12 reversed island flaps from forearm and 3 from dorsum of proximal phalanx of index fingers. Eight degloved injuries of thumbs were repaired by 8 reversed island flaps from forearm. Thirty-nine skin defects of thumbs were treated by pedicled island flaps in which 16 from dorsum of proximal phalanx of indcx finger and 23 from dorsum ofmiddle phalanx of index and middle fingers.