The authors analysed the results of two series of patients treated either by lengthening (16 cases) or digital pollicization (45 cases). The conclusions about the indications for the two techniques are as follows: When the amputation is proximal and the sole lesion, pollicization of the ring finger is preferred. In distal amputations in children, pollicization is still indicated, but in adults, lengthening, with a pedicle island-flap to give sensation is preferable. In amputations of the thumb associated with lesions of other digits, pollicization is not feasible; in these cases, the authors recommend a toe transplant using micro-surgical technique.