The authors describe a new flap to enlarge or create a first web in patients with congenital deficiencies of the hand. This lozenge-shaped flap is harvested from the dorsoradial aspect of the index finger based on a narrow proximal skin bridge protecting its axial vascularization. A dorsal skin graft of the donor site is avoided by closure using a rhomboid flap. Procedures in 16 patients were performed and reviewed; the only complication was insertion of a small split-thickness graft in five patients to avoid tension at the metacarpophalangeal joint level. The flap lengthened the web fold an average of 3.2 cm without “pseudolengthening” the thumb. (Plast. Reconstr. Surg. 107: 1458, 2001.)
From SOS Main Strasbourg, Hôpital de Hautepierre, Université de Strasbourg, Universidad de Las Palmas de Gran Canaria, and the Miami Hand Center. Received for publication March 29, 2000; revised June 21, 2000.
Guy Foucher, M.D.
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©2001American Society of Plastic Surgeons