Estawrow Mina A, Gad Ahmed M
Plastic and Reconstructive Surgery Department, Ain Shams University, Cairo, Egypt.
Plast Reconstr Surg Glob Open. 2022 Feb 22;10(2):e4130. doi: 10.1097/GOX.0000000000004130. eCollection 2022 Feb.
There are different approaches for reconstruction of little finger and dorsal hand defects. The ulnar parametacarpal flap, first introduced by Backhach et al in 1995, is considered a good option for reconstructing such defects. In this study, we elevated this flap on one perforator and applied it as a propeller flap. We then discussed the reliability of this flap and which perforator (the proximal or the distal one) is more reliable.
This study was carried out on 20 patients with different little finger and dorsal hand defects between June 2017 and March 2019. All defects were covered by perforator-based ulnar parametacarpal flaps. Ten flaps were based on the proximal perforator, whereas the other 10 were based on the distal perforator.
With a period of follow-up ranging from 6 months to 1 year, all flaps that were raised on the proximal perforator survived completely, whereas two of 10 flaps raised on the distal perforator showed venous congestion and also one flap showed partial necrosis of the distal one-third due to ischemia.
The perforator based ulnar parametacarpal flap is a reliable option for reconstruction of little finger and dorsal hand defects. It is more reliable when it is raised on the proximal perforator rather than on the distal one.
小指和手背缺损的重建有不同的方法。尺侧掌骨旁皮瓣由Backhach等人于1995年首次提出，被认为是重建此类缺损的一个好选择。在本研究中，我们在一个穿支血管上掀起该皮瓣并将其应用为推进皮瓣。然后我们讨论了该皮瓣的可靠性以及哪个穿支血管（近端或远端穿支血管）更可靠。
本研究于2017年6月至2019年3月对20例患有不同小指和手背缺损的患者进行。所有缺损均采用基于穿支血管的尺侧掌骨旁皮瓣覆盖。10个皮瓣以近端穿支血管为蒂，而另外10个以远端穿支血管为蒂。
随访6个月至1年，所有以近端穿支血管掀起的皮瓣均完全存活，而以远端穿支血管掀起的10个皮瓣中有2个出现静脉淤血，并且有1个皮瓣因缺血出现远端三分之一部分坏死。
基于穿支血管的尺侧掌骨旁皮瓣是重建小指和手背缺损的可靠选择。以近端穿支血管掀起时比以远端穿支血管掀起更可靠。
