Free "kite" flap:: A new flap for reconstruction of small hand defects

Small, thin, and pliable flaps are frequently required in hand surgery to reconstruct defects in functionally important areas such as the pulp or the "contact zones" of the digits. The innervated first metacarpal artery flap ("kite" flap) is a reliable procedure to restore sensibility in the thumb and the digits. Four microsurgical (free) kite flaps to the hand were performed between February, 1993 and August, 1999 in male patients. Follow-up examinations were performed in three patients. The static two-point discrimination in the kite flaps ranged from 8 to 15 mm and did not show any difference compared to flaps from the foot described in the literature. Semmes-Weinstein testing results ranged from normal to protective sensation with a normal sharp vs. dull discrimination. A free kite flap provides a valuable, safe alternative to venous flaps or other free flaps for reconstruction of small defects in the hand.