Pedicled hypothenar perforator flap: Indications and clinical application

Winsauer, Stefan; Gardetto, Alexander; Kompatscher, Peter

doi:10.1016/j.bjps.2016.03.001

Cited by 4 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 In addition, they require digital immobilization until the division of the pedicle and subsequently delayed rehabilitation. 18 Viable distant flaps for coverage of distal extremity defects are abundant; however, each has its own limitations. Arterialized venous flow-through flaps can offer the correct thickness for small finger defects; however, their tendency for congestion and edema, with possible subsequent necrosis, can complicate the postoperative course.…”

Section: Discussionmentioning

confidence: 99%

“…17 Other local options such as the pedicled hypothenar flap still lack an exact description of the design and range of coverage. 18 In addition, they require digital immobilization until the division of the pedicle and subsequently delayed rehabilitation. 18 Viable distant flaps for coverage of distal extremity defects are abundant; however, each has its own limitations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The First Dorsal Metacarpal Artery Perforator Free Flap: The Comet Flap

Abu‐Ghname

Lazo²,

Chade³

et al. 2022

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background: Distal extremity defects pose a particular challenge to the reconstructive surgeon; however, advances in perforator flaps have expanded the potential reconstructive options. In this article, the authors present their experience in reconstructing distal extremity defects using a thin, cutaneous free flap based on the perforator of the first dorsal metacarpal artery: the comet flap. Methods: A retrospective review was performed on all patients who presented with a distal extremity defect and underwent reconstruction using a comet flap between 2015 and 2019. Patient demographics, flap anatomy and harvest, and postoperative course were reviewed and analyzed. Results: A total of 16 patients were included. The mean patient age was 36.5 years. Trauma was the most common cause. The average defect size was 5.4 × 3.2 cm. The average pedicle length of the comet flap ranged from 3.5 to 30 cm, depending on involvement of the radial vessels. All donor sites underwent uncomplicated closure with local rhomboid flaps. One flap was complicated by an acute venous thrombosis that was successfully treated operatively. The flap survival rate was 95 percent. All patients were able to maintain their preoperative range of motion and were satisfied with their final outcome. Follow-up time ranged from 6 to 50 months. Conclusions: Local flaps remain an important reconstructive approach for distal extremity defects; however, in complex soft-tissue injuries, free tissue transfers become necessary. The comet flap is a safe, versatile, and reliable flap for reconstructing upper and lower extremity defects that can be performed in a single procedure under regional anesthesia. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The First Dorsal Metacarpal Artery Perforator Free Flap: The Comet Flap

Abu‐Ghname

Lazo²,

Chade³

et al. 2022

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

show abstract

Flaps Based on Palmar Vessels

Panse

Bindu

2020

Hand Clinics

View full text Add to dashboard Cite

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

Kunda,

Cai,

Dagum

2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Local flaps are commonly used for reconstruction of digital soft-tissue defects. There remains a paucity of options available for small finger volar and dorsal soft-tissue defects distal to the proximal interphalangeal joint. The purpose of this study was to analyze perforators along the hypothenar palmar region arising from the artery of the ulnar side of the small finger as it comes off the superficial palmar arch for consistency and potential to be used for perforator-based flap reconstruction of soft-tissue defects and joint coverage of the small finger. Methods: Four cadaveric upper extremities were injected with Microfil silicone injection compound. Dissection was performed from the superficial palmar arch to the ulnar digital artery of the small finger, and perforators were identified and analyzed for consistency and utility. Flap elevation was performed based on these perforators in a small finger reverse ulnar digital artery fashion. Results: All cadaveric dissections showed a suitable perforator pattern along the hypothenar palmar region with a minimum of 5 perforators available from which to base a flap to address dorsal and volar defects of the small finger. Two clinical examples are presented confirming the viability and utility of this flap. Conclusions: A detailed anatomic study with 2 clinical examples of this retrograde pedicle island flap is presented. The small finger reverse ulnar digital artery hypothenar palmar–based perforator flaps are a viable option with a reliable perforator pattern, providing a functional solution for reconstruction of soft-tissue defects and joint coverage of the small finger.

show abstract

Pedicled hypothenar perforator flap: Indications and clinical application

Cited by 4 publications

References 11 publications

The First Dorsal Metacarpal Artery Perforator Free Flap: The Comet Flap

The First Dorsal Metacarpal Artery Perforator Free Flap: The Comet Flap

Flaps Based on Palmar Vessels

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

Contact Info

Product

Resources

About