The second web bilobed island flap for thumb reconstruction

The second web bilobed island flap is described. The flap includes skin from the second web of the hand and the dorsum of the index and middle fingers. Usually the flap is based on the first and second dorsal metacarpal arteries, but it can be used with just the first dorsal metacarpal vessels in its pedicle. Sensation of the flap is provided by branches of the radial nerve. The flap has been successfully used to reconstruct 11 injured thumbs.