A reverse ulnar hypothenar flap for finger reconstruction

A reverse-flow island nap from the hypothenar eminence of the hand was appl ied in 11 patients to treat palmar skill defects, amputation injuries, or f lexion contractures of the little finger. There were three female and eight male patients, and their ages at the time of surgery averaged 46 years. A 3 x 1.5 to 5 x 2 cm fasciocutaneous flap from the ulnar aspect of the hypot henar eminence, which was located over the abductor digiti minimi muscle, w as designed and transferred in a retrograde fashion to cover the skin and s oft-tissue defects of the little finger. The flap was based on the ulnar pa lmar digital artery of the little finger and in thr ee patients was sensate d by the dorsal branch of the ulnar nerve or by branches of the ulnar palme r digital nerve of the little finger. Follow-up periods averaged 42 months. The postoperative course was uneventful for all patients, and all of the f laps survived without complications. The donor site was closed primarily in all cases, and Ilo patient complained of significant donor-site problems. Satisfactory sensory reinnervation was achieved in patients who underwent s ensory flap transfer, as indicated by 5 mm of moving two-point discriminati on. A reverse Island flap from the hypothenar eminence is easily elevated, contains durable fasciocutaneous structures, and has a good color and textu re match to the finger pulp. This flap is a good alternative for reconstruc tion of palmar skin and soft-tissue defects of the little finger.