Modified dorsal rotation advancement flap for release of the thumb web space

The dorsal rotational advancement flap described by Buck-Gramcko in 1998 is a good local flap for release of the thumb index web space. This paper describes a modification which broadens the apex of the flap and increases its length. This modification provides a long wide flap which releases the thumb index web space with suture lines far beyond the web. In addition, it provides a release of the palmar skin even when very tight in severe narrowing of the web. It is suitable for release of thumb-index syndactyly, severe narrowing of the web in thumb hypoplasia and congenital clasped thumb.