In a series of 12 patients incapacitated by persistent or recurrent pain in the palmar aspect of the hand and wrist, successful rehabilitation was aided by employing an abductor digit minimi muscle flap. It is emphasized that this muscle flap was utilized as an adjunct to microsurgical internal neurolysis and neuroma resection. Eleven of the 12 patients (92 percent) achieved good to excellent results in terms of relief of pain, plus either return to their previous job or vocational rehabilitation. The "salvage" nature, donor-site morbidity, and technical demands of the procedure are emphasized.