Fig 7A-9. Four-flap Z-plasty of the thumb web. A and B, two 120-degree-angle opposing Incisions are bisected to form four 60-degree flaps. C, design of the flaps in the first web space. D, incision, elevation, and undermining of the flaps. E, flap position after interposition. F, appearance of the thumb web following interposition of the flaps. (Adapted from Broadbent TR, Woolf RM: Thumb reconstruction with contiguous skin-bone pedicle graft. Plast Reconstr Surg 1960; 26:494-499. Strickland JW: Reconstruction of the thumb, in Green DP (ed): Surgery of the Hand, ed 2. New York, Churchill Livingstone Inc, 1988.)