The hands are a kind of cabled connector tissue between humans’ own bodies, humans, and the life. They are one of the excellent structures of body with no excess tissue whose loss can be tolerated well. Their functionality is as important as the integrity of the tissues. The absence of a healthy thumb causes more than 40% loss of functionality in the hand. However, it is difficult to predict how functional a thumb will be if its length is missing, its joints are stiff or painful, its skin is numb, or all of these together. Therefore, when performing thumb repair, the main goal should be to ensure mobile, painless, and sensory functionality as well as anatomical integrity. In order to best achieve this goal, it may sometimes be necessary to perform a few surgical procedures step by step. To achieve this, medical doctors have been working for years and continue to develop many new and better treatment methods. However, it is necessary to know that no matter how much we glue a broken glass, it will never be like its original state. It will do the job, but the crack mark will remain like a scar tissue, and the patient should be told about the expectations. Let us not forget that it is always better to have something, even if it is defective or missing, than to have nothing in place of the thumb. In contrast to today’s microsurgical repairs and free tissue transfers, which require high technology and skill but can yield much better results, we talked about alternative methods that can be applied more easily in case of unavailability of advanced technology and skills, and patient or trauma related conditions, high comorbidities for advanced methods. In this section, we listed the methods that were developed for thumb reconstruction and were widely used in their time.