The technique of neurovascular island flaps is described applied as an emergency operation in six patients who presented with considerable loss of substance of the fleshy pulp of the thumb or total loss of the terminal phalanx. The writers consider that the reconstructive method described by them is an advance on the traditional method, since not only can the matter be resolved in a single operative session, but epicritic sensitivity is maintained, the length of the thumb remains unaltered, better aesthetic results are obtained, and there are no vasomotor or sympathetic disorders.