Z-plasties and related procedures for the hand and upper limb.

The Z-plasty is a useful procedure in surgery of the upper limb for lengthening skin along a selected axis, for breaking up a straight line, and for obliterating webs. At least six geometric variables are considered in designing a conventional Z-plasty, and several modified designs must be considered. Geometrical models are useful guides in design, but biomechanical features are also important and must be incorporated in the plan.