Shen Xiang-Qian, Xu Ji-Hua
Department of Hand Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2010 Sep;26(5):321-4.
To discuss the therapeutic effect and clinical experience of a new technique of digital reconstruction with the free mesio-forearm flap based on perforator of ulnar artery.
We marked the line from the pisiformis to the condylus medialis humeri as the axis of the flap. We used Doppler to detect the site of the mesio-forearm ulnar perforator which is usually 9-10 cm proximal to the condylus medialis humeri as center of the flap. We designed the flap that contained perforator artery with its accompanying vein of the ulnar artery and a superficial vein around the center spot along the axis of ulnar artery. The wound at donor site was sutured directly. Neurorrhaphy was not conducted in any cases.
From June 2005 to June 2009, all 12 flaps survived with good quality and aesthetic contour. And no necrosis occurred. We conducted 6-36 months follow-up, and the result was satisfactory. The function of the fingers was reserved. Two-point discrimination differed from 6 cm to 12 cm.
The free ulnar perforator flap on mesio-forearm can repair digital defect with good therapeutic effect, leaving less morbidity at donor site.
探讨基于尺动脉穿支的游离前臂内侧皮瓣数字化重建新技术的治疗效果及临床经验。
以豌豆骨至肱骨内侧髁连线为皮瓣轴线。用多普勒探测前臂内侧尺动静脉穿支穿出点，通常位于肱骨内侧髁近端9～10cm处作为皮瓣中心。设计包含尺动脉穿支及其伴行静脉以及沿尺动脉轴线在中心点周围的一条浅静脉的皮瓣。供区伤口直接缝合。所有病例均未进行神经吻合。
2005年6月至2009年6月，12例皮瓣全部成活，质地良好，外形美观，无坏死发生。随访6～36个月，效果满意，手指功能保留，两点辨别觉在6cm至12cm之间。
游离前臂内侧尺动脉穿支皮瓣修复手指缺损疗效良好，供区损伤小。
