The surgical anatomy of the dorsal carpal branch of the ulnar artery: basis for a neurovascular dorso-ulnar pedicled flap.

In order to design a neurovascular flap from the dorso-ulnar aspect of the midhand for pedicled transfer to adjacent or distant locations, the surgical anatomy of the dorsal carpal branch of the ulnar artery (DCBUA) was studied in 12 cadavers. The DCBUA was identified in all specimens. It originates from the ulnar artery 1.6 to 4.4 centimeters proximal to the ulnar styloid, passing deep to the flexor carpi ulnaris tendon, and spirals superficially to the extensor retinaculum around the ulnar border of the wrist. Its terminal branches supply an undetermined area of skin overlying the ulnar metacarpals and the ulnar hypothenar region, either by direct cutaneous supply (3/12 specimens) or by septo-cutaneous perforators (8/12 specimens). The DCBUA is closely related to the dorsal sensory branch of the ulnar nerve, with which it supplies a common neurovascular territory.