Pedicle complex tissue flap transfer for reconstruction of duplicated thumbs with unequal size

Table 2 ALURRA criteria

Criteria	Score
	2	1	0
Alignment	< 10°	10°-20°	> 20°
IP joint deviation (radial/ulnar)
MP joint deviation (radial/ulnar)	< 10°	10°-20°	> 20°
Ulnar instability
IP joint	< 5°	5°-15°	> 15°
MCP joint	< 20°	20°-40°	> 40°
Radial instability
IP joint	< 5°	5°-15°	> 15°
MCP joint	< 20°	20°-40°	> 40°
Range of motion
IP joint	> 70°	50°-70°	< 50°
MCP joint (% of opposite thumb)	> 70°	50°-70°	< 50°
Aesthetical aspects
Circumference (% of opposite thumb)	75-100	50-75	< 50
Length	75-100	50-75	< 50
Nail size	75-100	50-75	< 50
Nail deformities	None	Small ridge	Severe deformation

A total score above 20 is categorized as good, between 13 and 20 as moderate, and less than 13 as poor. IP: Interphalangeal; MCP: Metacarpophalangeal.