Coverage of a soft tissue defect of the thumb that cannot be replanted or without bone shortening is difficult to achieve, but it is essential to preserve key-pinch and to restore a sensible and painless pulp.We reviewed retrospectively 107 cases of thumb reconstruction in an emergency situation using the following flaps: Moberg, radial innervated cross-finger, Venkataswami-Subramanian, Foucher, Tezcan, and Littler.The choice of the flap was determined by the extension and location of the injury; Foucher flap (56 cases) was the most used one, and it proved to be the best choice as shown by the results. Nevertheless, Tezcan flap also proved to be a good alternative.