Free distal ulnar artery perforator flaps for the reconstruction of a volar defect in fingers.

Abstract

A volar defect in finger is a common manifestation in hand injuries, and proper volar coverage of fingers is of great significance for hand function and cosmetic appearance. The aim of our study is to investigate the feasibility of reconstructing a volar defect in fingers with the free ipsilateral distal ulnar artery perforator flap under the brachial plexus block. Eight free distal ulnar artery perforator flaps were used to reconstruct volar defects in eight fingers. The involved fingers were three index fingers, three long fingers, one thumb, and one ring finger. The sizes of flaps ranged from 3.0 × 4.0 to 3.0 × 11.0 cm. All the flaps were harvested from the ipsilateral forearm of the injured fingers. The donor sites were primarily closed except in one case with a skin graft. The operation time ranged from 120 to 150 min, with an average of 130 min. All the operations were performed under brachial plexus block. All flaps survived completely without any complications during the 4-18 months follow-up. All the patients were satisfied with the hand function and the cosmetic appearance. It might be a good workhorse flap to reconstruct the volar defects in fingers in hand surgery with the free distal ulnar artery perforator flaps.