Moberg Flap (Palmar advancement flap)


- See:
      - Thumb Soft Tissue Defects
      - Amputation of Fingers and Hand

- Indications and Advantages:
    - most indicated for amputations distal to thumb IP joint, in which a V-Y flap cannot be used;
    - may cover upto 1.5 cm palmar defect (but not more than 2 cm);
    - provides near normal sensibility;
    - advancement flaps for lesser fingertip injuries usually will survive if volar flap incisions are not brought proximally, to the PIP joint;
    - in the thumb, the venous drainage is not depended on volar flap, and thus this technique is safer and the flap can be longer;

- Technique:
    - midlateral incision, dorsal to the neurovascular bundles;
    - flap is dissected off the flexor tendon sheath;
    - flap is advanced of palmar skin of thumb including neurovascular bundles;
    - advancement (helped by flexion of IP joint);
    - if flap remains under tension, consider proximal transverse incision w/ care to preserve N/V bundle, w/ subsequent placement of FTSG on 
         secondary defect;

- Disadvantages:
    - flexion contractures
    - potential for dorsal tip necrosis if neurovascular bundles injured;
    - flexion contractures
    - potential for dorsal tip necrosis if neurovascular bundles injured;
    - advancement flaps for fingertip injuries usually will survive if the volar flap incisions are not brought proximally, to the PIP joint;
         - in the thumb, the venous drainage is not depended on volar flap, and thus this technique is safer and the flap can be longer



The Moberg advancement flap for digital reconstruction.

The advancement pedicle flap for thumb injuries.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, May 22, 2012 4:19 pm