Repairing finger defects with free vascularized flaps based on the descending branch of the upper-wrist cutaneous branch of ulnar artery.

Abstract

Objective To study a new surgical method to repair finger defects with free vascularized flaps based on the descending branch of the upper-wrist cutaneous branch of ulnar artery, and evaluate the clinical effects.Methods From March 2001 to December 2006, 75 patients (79 fingers) suffered soft were treated using free flaps pedicled with the descending branch of the upper-wrist cutaneous branch of ulnar artery.There were 41 males (45 fingers) and 34 females (34 fingers), with the mean age of 31 years (ranged from 20 to 45 years).Among them, 59 cases of 62 fingers adopted emergency surgery or delay surgery to repair, 16 cases of the 17 fingers adopted selective operation to repair.Vascular variations were studied in the process.Results The grafted flaps in all 79 fingers of 75 patients successfully survived except for one necrosis case in the distal part of the flap, which was then healed with skin grafting.Three different types of variation of the upper-wrist cutaneous branch of ulnar artery were identified in the operation, including the origin and the number of cutaneous branches, and corresponding surgical approaches had contributed to successful survival of the flaps pedicled with vascular variations.Follow-up studies that lasted 6-24 months after the procedure revealed adequate texture and shape of the flaps with the two-point discrimination of 6-11 mm, did not match nerves, skin protection 6 months after the restoration of feeling, the functional recovery of the fingers being satisfying.Conclusion It can provide the relatively constant vascular anatomy and easy operation to repair finger defects with free vascularized flaps based on the descending branch of the upper-wrist cutaneous branch of ulnar artery, and get satisfied skin flap appearance, texture and feeling function. Key words: Surgical flaps; Ulnar artery; Finger injuries; Treatment outcome