Purpose: Local flaps are commonly used for digital reconstruction for soft tissue defects. There remains a paucity of options available for small finger volar proximal interphalangeal joint coverage. The purpose of this study was to analyze perforators along the hypothenar eminence arising from the artery of the ulnar side of the small finger as it comes off the superficial palmer arch for consistency and potential to be used for perforator-based flap reconstruction of the small finger proximal interphalangeal joint.
Methods: Four cadaveric upper extremities were injected with Microfil® silicone injection compound. Dissection was performed from the superficial palmer arch to the ulnar digital artery of the small finger and perforators were identified and analyzed for consistency and utility. Flap elevation was performed based on these perforators in a small finger reverse ulnar digital artery fashion.
Results: All cadaveric dissections showed a suitable perforator pattern over the hypothenar region with a minimum of 5 perforators available for which to base a flap.
Conclusion: Small finger reverse ulnar digital artery hypothenar-based perforator flaps for small finger proximal inter- phalangeal joint reconstruction are a viable option with a reliable perforator pattern, providing a functional solution for the surgeon’s armamentarium.
