Dorsal pedicle flap for resurfacing a moderate thumb-index web contracture release

If a dorsal rotational flap is chosen for reconstructive resurfacing of a moderate thumb-index flexion-adduction web contracture release, the design advised in this paper is advocated as the most physiologic use of skin with least torsion on the pedicle base. The key to the procedure is designing the pedicle to cross the axis of motion of the pedicle tip on one side, preferably the thumb, and the pedicle base on the opposite side.