Degloving injuries of the hand characteristically result in avulsion of a skins flap which is often irreparably damaged and will require replacement by a free or pedicle graft. Such a graft on the distal volar surface of the digits gives poor sensory quality for useful manual dexterity, but may be corrected by local-tissue shift or a sensory island pedicle when the disability is sufficiently great.
However, in the severe degloving injury there may not be sufficient normal digital skin for such restorative techniques. A technique for transposing a flap of palmar skin onto the volar surface of the dominant injured digit is illustrated by two clinical examples.
Details of the anatomy of the palmar cutaneous nerves are described in relation to the design of palmar sensory skin pedicles. Quality of sensation in the transposed tissue is evaluated.