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Pedicled hypothenar perforator flap: Indications and clinical application
S Winsauer1, A Gardetto1, P Kompatscher1
1Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria.
Summary
The pedicled hypothenar perforator flap effectively reconstructs soft-tissue defects on the palm and little finger. This technique offers a viable solution with low donor-site morbidity for hand surgeons.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Soft-tissue defects in the palm and fifth finger present significant challenges in hand surgery.
- Planning and harvesting pedicled hypothenar perforator flaps offer a potential solution for reconstruction.
Observation:
- A hypothenar perforator flap was utilized for soft-tissue defect reconstruction in 17 patients.
- Defects varied in location, affecting the proximal phalanx of the fifth finger, palm, or both, with sizes up to 7.9 cm².
Findings:
- Eleven flaps achieved primary healing; six experienced partial necrosis, with four requiring revision.
- Despite complications, all 17 defects were successfully covered, and patients achieved full functional recovery within an average of 26.6 days.
Implications:
- The pedicled hypothenar perforator flap is a valuable option for ulnar-sided palm and little finger soft-tissue defect reconstruction.
- Its thin profile and low donor-site morbidity make it a favorable choice for hand surgeons.
- This flap provides a reliable method for restoring form and function in challenging hand defects.
