Thumb Reconstruction With Thin Proximal Ulnar Perforator Free Flap.

Area of Science:

• Microsurgery
• Hand Surgery
• Plastic Surgery

Background:

• Thumb defects often require complex reconstruction for optimal function.
• Free tissue transfer is indicated for large thumb defects.
• Alternative free flaps have drawbacks that limit their widespread use.

Observation:

• A patient with squamous cell carcinoma of the thumb underwent resection of distal phalanx and interphalangeal joint soft tissue.
• The defect was reconstructed using a proximal ulnar perforator flap sourced from the proximal volar forearm.
• The flap provided pliable, texture-matching skin coverage for exposed vital structures.

Findings:

• The proximal ulnar perforator flap demonstrated successful coverage of the thumb defect.
• The patient reported high satisfaction with the aesthetic outcome after 12 months.
• Minimal donor-site morbidity and no functional impairment were observed.

Implications:

• The proximal ulnar perforator flap is a viable and reliable option for thumb reconstruction.
• Its constant vascular anatomy and low risk to neurovascular bundles enhance its safety.
• This flap can be a valuable tool for hand surgeons managing complex thumb injuries.