Skin Defect of the Finger Repaired with the Free Flap Accompanying with Tendon which Pedicled on the Palmar Branch of the Supracarpal Perforator of Ulnar Artery

Introduction: To explore the clinical effect of the free flap with supracarpal palmar perforator branch of ulnar artery and partial flexor carpi ulnaris tendon repairing dorsal skin defect of finger.

Methodology and Material: 15 patients with dorsal skin defect of finger were repaired with the free flap with supracarpal palmar perforator branch of ulnar artery and partial flexor carpi ulnaris tendon. The flaps were 2.0cm×2.5cm－3.0cm×6.0cm.The size of the tendons with half thickness were 2.0cm－5.5cm.There were 6 cases repaired the medial cutaneous nerve of forearm and the dorsal digital nerve, the other 9 cases were not repaired the nerve. There were 5 cases to coincide with the common palmar digital artery directly, 4 cases with the branch of the digital artery and 6 cases with the dorsal digital artery. The donor were all directly sutured.

Results: The flaps were all survival.，the flaps were not bulky, the sensations were S3-S3+. The scars of the abdominal donor sites were small. According tentative standard of the functional evaluation of the replantation of broken limb evaluated by Chinese Medical Association, the results were excellent in 11 cases, good in 3 cases, fair in 1 case, and the excellent and good rate was 93.30%. The scars of the donor sites were small. The motion and power of wrists were normal.

Conclusions: Using the free flap with carpal palmar perforator branch of ulnar artery and partial flexor carpi ulnaris tendon to repair dorsal skin defect of finger may achieve composite repairment in one operational site, detachment of the vessel was quick, the hand appearance was not broken and the donor was mild destroyed. This flap is a better treatment to repair the hand skin and soft tissues defects