Case History/examination:
A 26 year old, previously healthy, male presented to the emergency department following an electric saw injury to the left thumb while cutting wood at work. His dominant hand is the right hand. No past medical or surgical history. Review of system was otherwise negative. He brought the amputated part with him and it was wrapped in wet gauze and placed in a container that was immersed in ice. On examination, he was vitally stable, primary and secondary survey were unremarkable except for the base of the left thumb amputation just distal to the metacarpophalangeal joint (figure 1).