Web space release

As the degree of thumb hypoplasia increases, so does the extent of tightness within the first web space. A deepening or widening of the web may have benefits in terms of both function and cosmesis. This may be achieved with any of the following options:

• local flaps:
  • z-plasty
  • four-flap z-plasty
  • jumping-man plasty
  • dorsal rotation flap
• distant:
  • posterior interosseous artery flap
  • groin flap
• free groin flap