[Radial island flap for the reconstruction of the 1st commissure]

The fasciocutaneous radial forearm island flap was used in six cases for reconstruction of the first web space after tumor resection, severe burns, a complex hand injury and a congenital adduction contracture of the thumb. Reconstruction of a deep and wide first web was possible in all cases. All flaps except the last one operated fifteen months ago have recovered protective sensation although nerve reconstruction was performed only twice. The donor defect could be closed directly in three cases. Corrective surgery for an unsightly scarred donor area was considered in one case. The radial forearm island flap is therefore a reliable and low-risk procedure for coverage of first web defects.