The Keystone Flap Technique to Reconstruct Palmar Defects Resulting from Dupuytren’s Fasciectomy: The Province of Orthopaedic Hand Surgeons

Closure of soft tissue defects using Keystone design island flaps dermatomally aligned provides an alternative to the perforator flaps routinely used. The Keystone retains the embryological communications up perforator stalks where somatic and autonomic fibres are conveyed, associated with lymphatic drain channels helping to resolve postoperative oedema. By leaving these intact, these filamentous fibres give a possibility of returning to anatomical normality for closure of soft tissue defects, often the province of microvascular repairs.