Apply improved first dorsal metacarpal flap to correct mild-to-moderate thumb web contracture realeasing

Objective To introduce the improvement of the flap from the dorsal site of the index in the application of treatment in the thumb web contracture. Methods Apply improved first dorsal metacarpal flap for 111 cases of patients of the thumb web contracture releasing. The original island or tongue-shaped flaps was modified to be the local flap transfer to the thumb web. Surgical method simplified. Before thumb web contracture was released, the flap was taken from ulnar aspect to radial aspect on the dorsum of the index. The flap was transferred to cover the soft tissue defect on the first web space following the contracture releasing. Flap donor area was closed by split-thickness skin graft. Results One hundred and eleven cases of flaps survived. After the 3-18 months (mean follow-up of 8.5 months), the local appearance, thumb function recovered well for 94.6 percent. Conclusion Improved first dorsal metacarpal flap is effective methods in thumb web contracture releasing. Key words: Thumb web contracture; Surgical flap; Transplantation; Microsurgery