The proximal inset thenar flap for fingertip reconstruction

Modifications of the thenar flap are described that permit a larger area of skin and volume of tissue to be transferred for digital reconstruction while permitting primary closure of the flap donor site. By means of insetting the flap initially into the proximal portion of the finger defect, a more secure blood supply for this larger volume of tissue is obtained and a more natural restoration of digital length, pulp contour, and nail matrix support is achieved at the final insetting.