F.M. is a 45-year-old left-handed gentleman who sustained a chainsaw injury to his right thumb in April 2012 resulting in an incomplete amputation at the metacarpophalangeal joint level. FM suffered an open fracture-dislocation of the metacarpophalangeal joint with a displaced radial articular fragment of the metacarpal with disruption of the radial collateral ligament of the metacarpophalangeal joint, the thenar musculature, the radial 35% of the extensor pollicics longus and the radial neurovascular bundle. Following ORIF, the metacarpohalangeal joint capsule, radial collateral ligament of the metacarpophalangeal joint and the radial digital nerve were repaired. The thenar muscles were repaired and soft tissue flap procedure performed.