We describe a young man who suffered a severe mutilating injury of the hand and forearm while working as a cheesemaker. He underwent a complex reconstruction of his right adominant hand including a heterotopic thumb replantation into the distal radius and combined with an emergency flow-through anterolateral thigh flap.
Keywords: Vilkki-Procedure; anterolateral thigh (ALT) flap; emergency free flap; flow-through flap; mutilating injury.