Further experience with the bipedicled neurovascular island flap in thumb reconstruction

A procedure is described for the transfer of sensibility to the thumb by means of an island flap. The donor site is the dorsoradial surface of the index finger. The flap is supplied by two neurovascular pedicles. The palmar one includes the digital artery of the index and the dorsal branch of the palmar digital nerve. The dorsal pedicle includes the dorsoradial artery and nerve of the index and one or two superficial veins. This procedure was used in 29 patients without early postoperative complications. The advantages of the method are the resurfacing of the prehensile surface of the thumb by a flap with good arterial and venous supply while preserving the innervation and the palmar skin of the donor finger.