[Closure of rheumatic palmar perforations of the wrist capsule with a flap of retinaculum flexorum].

In 53 hands with rheumatoid arthritis, bony spurs of the scaphoid and trapezium were found perforating the capsule of the radial wall of the carpal tunnel. After removal of the spurs, the remaining capsular defect was covered by a flap of the flexor retinaculum. The flap is raised from the flexor retinaculum in a width of approximately 15 mm by parallel transverse incisions and is based radially. Then it is brought down to the defect and sutured to the local ligaments. The blood supply of the retinacular flap is well preserved. The flap provides a reliable cover of the capsular defect as well as a smooth gliding surface for the flexor tendons.