Reconstruction of hand defects using the distally pedicled dorsoulnar fascial flap based on the dorsal descending branch of the ulnar artery

Objective To evaluate the clinical efficacy of the distally pedicled dorsoulnar fascial flap based on the dorsal descending branch of the ulnar artery in reconstructing hand defects.Methods Reverse transplantation and reconstruction was performed using the distally pedicled dorsoulnar fascial flap based on the dorsal descending branch of the ulnar artery for 24 patients with hand skin/soft tissue defects,including 6 cases of palmar ulnar wounds,3 cases of dorsal ulnar wounds,5 cases of palmar ring finger defects,4 cases of palmar little finger defects,3 cases of dorsal ring finger defects,and 3 cases of dorsal little finger defects.Phase I emergency surgery was conducted for 19 cases,and Phase Ⅱ surgery was performed for 5 cases with scar contracture.Results All flaps of 24 cases survived.Follow-ups lasted for 3 to 36 months(12±3 months in average),suggesting favorable appearance and texture of grated flaps without pigmentation.The two-point discrimination was 6～9 mm in 13 cases that received sensory nerve reconstruction.Scar contracture was relieved in 5 patients,and the passive activities were markedly improved.Conclusions Given the stable vascular anatomy,the application of the distally pedicled dorsoulnar fascial flap based on the dorsal descending branch of the ulnar artery serves as a simple and high-survival approach in repairing hand defects.