Procedure - Thenar Flap

Location Radial proximal palm / Thenar area, proximal to thumb flexion crease
Vascular supply Random: dermal plexus
Island / free: Superficial volar branch of radial artery
Pedicle type Skin Yes
Island Probable
Reverse N/A
Free Yes
Variations Skin  Yes
Sensory No
Fascial Probable
Split No
Dimensions Min: Any Max: 1 X 3 cm with tight primary closure
Thickness Medium
Donor defect Close primarily? Yes
Visibility Usually minimal
Ideal uses Fingertip cover. Less PIP flexion needed for more ulnar fingers. 
Disadvantages Beefy hands may not allow small fingertip to reach the thenar area. PIP flexion contractures are more likely if not hyperextensible preop or if flap is divided after 2 weeks.
Tips, misc and pics Inject PIP joint with 1 mg Kenalog at the time of flap placement to lessen chance of postop contracture.

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