Dorsal Rotation Flap for Centralization in Radial Longitudinal Deficiency

Purpose: The purpose of this report is to present the results of a dorsal rotation flap for centralization in the treatment of radial longitudinal deficiency. Methods: All patients surgically treated for radial longitudinal deficiency with a centralization procedure and use of the dorsal rotation flap between 1996 and 2006 were retrospectively reviewed. Results: Twenty-one limbs in 15 patients treated with centralization using the dorsal rotation flap were reviewed, with photographs of the scar available for review for 15 limbs in 10 patients. There were no primary wound-healing problems, no hypertrophic scarring, and no color mismatch. In the 15 limbs with available photographs, all scars were rated as good. Use of this incision allowed good surgical access to the necessary structures on the radial and ulnar side of the wrist to allow for centralization. Conclusions: The dorsal rotation flap allows rotation of the skin in a radial direction while the hand and carpus are rotated in an ulnar direction; the redundant skin on the ulnar side of the wrist is rotated to compensate for the shortage of skin on the radial side of the wrist. This report describes use of the dorsal rotation flap with no complications attributable to the surgical approach. Type of study/level of evidence: Therapeutic IV.