Novel Perforator Propeller Flap from the Palm for Dupuytren's and Post-Traumatic Scar Contractures

The palm is prone to skin contractures due to Dupuytren's contractures or trauma. To cover skin defects after contracture release and prevent re-contracture, surgeons prefer flaps to skin grafts. The perforator propeller flap is one of the best local flaps; however, there are few reports on this method. In a perforator mapping study in healthy volunteers, color Doppler ultrasonography showed that the perforator vessels were located around the metacarpophalangeal joints. Five patients with Dupuytren's contracture and one with post-traumatic scar contracture underwent novel perforator propeller flap reconstruction using perforator vessels around the metacarpophalangeal joint in the second, third, or fourth intermetacarpal spaces. Flap sizes ranged from 11 × 22 to 16 × 50 mm², and all flaps survived completely. Our propeller flap is useful for the reconstruction of distal palmar skin defects, especially those less than 16 mm in width.