Purpose: To describe and evaluate the anatomical skin shape of the first web space in cadavers and to guide flap design for this area.
Methods: Twelve cadavers (24 hands on both sides) were selected. Marker points were chosen based on the characteristics of the first web for morphological measurement and observation. The morphological characteristics of the first web under the radial or palmar abduction position of the thumb were measured and compared. The best morphologic features and parameters of the first web repairing flap were obtained.
Results: When the thumb was in the palmar abduction position, the maximum distance a(p) was 6.78 ± 0.72 cm and the skin area s(p) was 20.09 ± 2.63 cm2, both of which were significantly greater than the distance a(r) of 5.86 ± 0.74 cm and the skin area s(r) of 17.39 ± 2.15 cm2 when the thumb was in the radial abduction position (P < 0.05). There was no significant difference in the length b(r) and b(p) of the long axis of the flap between two different abduction positions (P > 0.05). It is found that the shape of the first web area was not a symmetrical spindle but an irregular quadrilateral inclined to the index finger side.
Conclusion: The flap design and measurement for the first web space covering should take the maximum palmar abduction position of the thumb as a reference. The asymmetric quadrilateral flap design is more in line with the anatomical and morphological characteristics of the region.
Keywords: First web space; Measurement; Morphology; Surgical flap.
Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.