A palmar approach for insertion of a free, nonvascularized phalangeal transfer.

Free nonvascularized phalangeal transfer from a toe to congenitally hypoplastic digits, is an established procedure in the repertoire of digit reconstruction. The hypoplastic digit is frequently flexed, due to shortage of palmar soft tissues. The phalanx must be transferred intact, with a complete periosteal covering. A new technique of incision and dissection is described utilizing a palmar V approach, closed after skin advancement, as a Y. This permits ample visualization of the digital envelope to receive the phalanx, protection under direct vision of the digital bundles, and simultaneous correction of the deficient palmar skin, without tension.