The extended palmar advancement flap

Abstract

A technique is presented that permits resurfacing up to 3 cm of palmar skin loss from the thumb, while preserving thumb length, minimizing thumb joint flexion contracture, and providing normal sensibility. The classic Moberg palmar advancement flap is extended proximally onto the thenar eminence. The radial and ulnar defects created by the distal advancement of the flap are closed by two additional local rotation flaps. Scarring is acceptable and follows natural lines. The technique is applicable for both primary repair and secondary reconstruction.