The authors designed a bi-lobed island flap of the second web pedicled with the first and the second dorsal metacarpal arteries. Since 1993, five cases of acute thumb avulsion have been repaired using this flap. The size of the flaps ranged from 3 cm x 6 cm to 6 cm x 7 cm. All flaps survived with primary healing of the incisions. Three to nine months' follow-up showed that the flaps were thin and had sensation. The function and appearance of the reconstructed thumb were satisfactory. The bi-lobed island flap of the second web is a valuable method for the repair of thumb avulsion.