title: Island volar advancement flap for reconstruction of thumb defects.
abstract: BACKGROUND
  The volar advancement flap of the thumb described by Moberg has been used for pulp defects up to 1 to 1.5 cm since its mobility is quite limited due to the stiff nature and fibrous connections of the regional skin with underlying structures. There have been several attempts to increase the mobility of this useful flap by adding V-Y and Z-plasty concepts into the technique. These modifications could provide a slight increase in the flap advancement and achieve closure of defects up to 2 cm in length at best.
  
  
  METHODS
  In this study, we describe the island volar advancement flap of the thumb in which all attachments, except the neurovascular pedicle of the flap, were divided to provide maximum mobility and advancement. This technique was used in 12 patients for reconstruction of traumatic defects of the distal thumb up to 3 to 3.5 cm in length.
  
  
  RESULTS
  The flaps healed uneventfully in all patients. There was no patient with flap failure. All patients were followed up for 2 to 6 years (4 years on an average). Our results revealed sensible and durable skin coverage with maximum preservation of the thumb length.
  
  
  CONCLUSIONS
  The island volar advancement flap seems to be a safe and useful procedure for thumb reconstruction. Providing a 1.5 cm of extra flap advancement, this new procedure enables us 1-stage closure of considerably large defects and is a critical achievement in thumb reconstruction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mutaf
authors.forename: Metin
authors.initials: M
authors.lastname: Temel
authors.forename: Ertan
authors.initials: E
authors.lastname: Günal
authors.forename: Dağhan
authors.initials: D
authors.lastname: Işık
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult