The Small Finger Reverse Ulnar Digital Artery Hypothenar Palmar Perforator Flap: An Anatomical Study With Clinical...

Area of Science:

• Plastic Surgery
• Hand Surgery
• Anatomy

Background:

• Local flaps are standard for digital soft-tissue defect reconstruction.
• Limited options exist for distal small finger volar and dorsal defects.
• Perforator-based flaps offer a potential solution for these challenging defects.

Purpose of the Study:

• To analyze perforators in the hypothenar palmar region arising from the ulnar digital artery of the small finger.
• To assess the consistency and utility of these perforators for flap reconstruction.
• To evaluate their potential for reconstructing distal small finger soft-tissue defects and joint coverage.

Main Methods:

• Cadaveric dissection of four upper extremities injected with Microfil.
• Identification and analysis of perforators from the superficial palmar arch to the ulnar digital artery.
• Elevation of reverse ulnar digital artery flaps based on identified perforators.

Main Results:

• Consistent perforator patterns were observed in the hypothenar palmar region.
• A minimum of five perforators were available for flap-based reconstruction.
• Two clinical cases confirmed the flap's viability and utility for dorsal and volar defects.

Conclusions:

• The small finger reverse ulnar digital artery hypothenar palmar-based perforator flap is a viable reconstructive option.
• This flap demonstrates a reliable perforator pattern.
• It provides a functional solution for soft-tissue defects and joint coverage of the small finger.