Anatomical basis for a fasciocutaneous flap from the hypothenar eminence of the hand

Abstract

Thirty-two fresh cadaver hands were perfused with a silicone rubber compound (Microfil) and dissected to explore the vascular and neural anatomy of the hypothenar eminence, in order to assess the possibility for free or pedicled island flaps from this area. In five specimens Microfil was selectively injected into the ulnar palmar digital artery of the little finger to determine the skin territory nourished by this artery. The hypothenar eminence was divided into three territories according to the type of nutrient artery supplying each territory. Among the three territories, the distal half of the ulnar aspect of the hypothenar eminence (approximately 3 × 2 cm), located over the abductor and flexor digiti minimi muscles, had a constant vascular and neural supply from the ulnar palmar digital artery of the little finger and the dorsal or palmar cutaneous branch of the ulnar nerve. This fasciocutaneous area provides a new and feasible donor site for free or pedicled island skin flaps to repair palmar skin defects of the fingers.