REVERSE ULNAR PARAMETACARPAL ARTERY FLAP FOR SOFT TISSUE DEFECTS OF HAND

Authors

  • Saeed Ashraf Cheema

Abstract

Background: Burn injuries and post burn contractures of the little fingers and areas around arequite common. Release of these contractures may lead to full thickness soft tissue defects whichneed soft tissue cover. Similarly, mechanical trauma and also road traffic accidents, quite oftenlead to soft tissue defects of hand. Objective of this study was to evaluate the role of reverseulnar parametacarpal artery flap in providing soft tissue cover for various full thickness softtissue defects at the base of little finger and adjacent areas on palmar and dorsal aspects.Methods: It was an observational study, conducted at Department of Plastic Surgery, ServicesHospital, Lahore. Study included ten cases with three females and seven male patients. Six ofthe patients had severe post-burn contractures of little finger, two had the involvement of theadjacent palm areas as well and one case had contracture along the mid palm crease. One casehad post mechanical trauma soft tissue defect at dorsal aspect of 4th web space. Contractureswere released and resulting soft tissue defects were reconstructed with reverse ulnarparametacarpal artery flap. Age ranged from 9 to 42 years with a mean age of 20.3 years.Results: This flap was utilised in ten cases. All flaps survived, one of the cases developedepidermolysis of whole of the flap which healed uneventfully. Conclusion: Flap is a localoption to cover the soft tissue defects of little finger and areas around thus involves the sameoperative field. Skin texture and features of the donor site also resemble the recipient area. Thedefect site is closed primarily.Keywords: Contractures, little finger, reconstruction, metacarpal artery flaps

References

Cheema SA. Patterns of hand injuries and treatment

modalities. Esculapio J Services Inst Med Sci 2006;2:26–9.

Rezende MR, Junior RM, Cho AB, Hasegawa OH, Ribak S.

Anatomic study of the dorsal arterial system of the hand. Rev

Hosp Clin Fac Med Sao Paulo 2004;59:71–6.

Bakhach J, Saint Cast Y, Gazarian A, Martin D, Comtet JJ,

Baudet J. The Para Metacarpal Ulnar Flap, Anatomical Study

& Clinical Application. Ann Plast Aesthet Surg

;40(2):136–47.

Bakhach J, Martin D, Baudetj. The Para Metacarpal Ulnar

Flap, Experience on Ten Clinical Cases. Ann Plast Aesthet

Surg 1996;41:269–75.

Earley M, Milner R. Dorsal metacarpal flaps. Br J Plast Surg

;40:333–41.

Iselin F. The flag flap. Plast Reconstr Surg 1973;52:374–7.

Foucher G, Braun J. A new islanded flap transfer from the

dorsum of the index to the thumb. Plast Reconstr Surg

;63:344–9.

Yousif NJ, Ye Z, Sanger JR, Arria P, Gilbert A, Matloub HS.

The versatile metacarpal and reverse metacarpal artery flaps

in hand surgery. Annals Plast Surg 1992;29:523–31

Coleman SS, Anson BJ. Arterial patterns in the hand based

upon a study of 650 specimens. Surg Gynecol Obstet

;113:409–24.

Olave E, Prates JC, Gabrielli C, Mandiola E.. Perforating

branches: Important contribution to the formation of the

dorsal metacarpal arteries. Scand J Plast Recontr Hand Surg

;32:221–7.

Omokawa S, Tanaka Y, Ryu J, Kish VL. The anatomical

basis for reverse first to fifth dorsal metacarpal arterial flaps.

J Hand Surg Br 2005;30:40–4.

Published

2010-06-01