Hypothenar island flap: A safe and excellent choice for little finger defects

ABSTRACT

Soft-tissue defects of the little finger are challenging especially when bone, tendon or vascular pedicle is exposed because of trauma. The hypothenar island flap is easy to harvest and has a good colour and texture match to the little finger pulp. We present nine clinical cases of soft tissue defects of the little finger covered using the reversed hypothenar fasciocutaneous island flap. This article intends to highlight the ease of elevation and good clinical results of the hypothenar flap which is rarely used.

KEY WORDS

Hypothenar island flap - island flap - soft-tissue defects of the little finger

 

Conflicts of interest

There are no conflicts of interest.

• REFERENCES

• 1 Wolff GA, Patrón AS, Herrera O, Posso C. Reconstruction of volar digital defects: Clinical experience with the hipothenar flap. Tech Hand Up Extrem Surg 2010; 14: 191-5
• 2 Omokawa S, Yajima H, Inada Y, Fukui A, Tamai S. A reverse hypothenar flap for finger reconstruction. Plast Reconstr Surg 2000; 106: 828-33
• 3 Bendz P. The functional significance of the fifth metacarpus and hypothenar in two useful grips of the hand. Am J Phys Med Rehabil 1993; 72: 210-3
• 4 Han SK, Lee BI, Kim WK. The reverse digital artery island flap: Clinical experience in 120 fingers. Plast Reconstr Surg 1998; 101: 1006-13
• 5 Chase RA, Hentz VR, Apfelberg D. A dynamicmyocutaneous flap for hand reconstruction. J Hand Surg Am 1980; 5: 594-9
• 6 Iwasawa M, Ohtsuka Y, Kushima H, Kiyono M. Arterialized venous flaps from the thenar and hypothenarregions for repairing finger pulp tissuelosses. Plast Reconstr Surg 1997; 99: 1765-70
• 7 Gellis M, Pool R. Two-point discrimination distancein the normal hand and forearm: Applicationtovarious methods of fingertip reconstruction. Plast Reconstr Surg 1977; 59: 57-63
• 8 Kojima T, Endo T, Fukumoto K. Reverse vascular pedicle hypothenar island flap. Handchir Mikrochir Plast Chir 1990; 22: 137-44
• 9 Toia F, Marchese M, Boniforti B, Tos P, Delcroix L. The little finger ulnar palmar digital artery peforator flap: Anatomical basis. Surg Radiol Anat 2013; 35: 737-40
• 10 McLean KM, Sacks JM, Kuo YR, Wollstein R, Rubin JP, Lee WP. Anatomical landmarksto the superficial and deep palmar arches. Plast Reconstr Surg 2008; 121: 181-5
• 11 Strauch B, de Moura W. Arterial system of the fingers. J Hand Surg Am 1990; 15: 148-54
• 12 Hwang K, Han JY, Chung IH. Hypothenar flap based on a cutaneous perforator branch of the ulnar artery: An anatomic study. J Reconstr Microsurg 2005; 21: 297-301
• 13 Dellon AL, Kallman CH. Evaluation of functional sensation in the hand. J Hand Surg Am 1983; 8: 865-70
• 14 Irwin MS, Gilbert SE, Terenghi G, Smith RW, Green CJ. Cold intolerance following peripheral nerve injury, Natural history and factors predicting severity of symptoms. J Hand Surg Br 1997; 22: 308-16
• 15 Edwards EA. Organization of the small arteries of the hand and digits. Am J Surg 1960; 99: 837-46
• 16 Hao PD, Zhuang YH, Zheng HP, Yang XD, Lin J, Zhang CL. et al Theulnarpalmarperforatorflap: Anatomical study and clinical application. J Plast Reconstr Aesthet Surg 2014; 67: 600-6
• 17 Groenevelt F. Some aspects of the burned little finger. Br J Plast Surg 1986; 39: 225-8
• 18 Xarchas KC, Tilkeridis KE, PElekas SI, Kazakos KJ, Kakagia DD, Verettas DA. Littler’s flap revisited: An anatomic study, literature review, and clinical experience in the reconstruction of large thumb-pulp defects. Med Sci Monit 2008; 14: CR568-73
• 19 Basu I, Markeson D, Evgeniou E, Iyer S. Revers digital artery flap from radial and ulnar borders of palm. Tech Hand Up Extrem Surg 2012; 16: 110-3