Fascial Flaps Based on Distal Ulnar and Radial Artery Perforators for Covering Hand Defects

The clinical effectiveness of adipofascial flaps based on distal ulnar or radial artery perforators was demonstrated in a series of 13 patients with severe hand injuries and soft-tissue defects requiring coverage.

There were 9 male and 4 female patients and their ages ranged between 23 and 69 years; the defects were 6 dorsal and 4 palmar, one with both above mentioned aspect defects, and two with thumb or total digit amputations. In the patients with a dorsal defect, the extensor tendons were intact in 2 cases, reconstructed in 2 cases and left without reconstruction in 2 cases using silicon rods.

A fascial flap based on a distal ulnar or radial artery perforator was fashioned and used to cover the defect following debridement, covered with a split-thickness skin graft, and immobilized for 2 weeks.

All cases were followed up for at least 6 months. The donor and recipient sites healed uneventfully, and the functional result was very good for joint range of motion of the wrist and with the hand at close to normal range (extension or flexion deficit less than 15 degrees). The aesthetic result was satisfactory.

The described fascial flaps offer several advantages over other local flaps, are easy to perform, and effectively cover both dorsal and palmar hand defects without serious functional deficits to the upper limb.