抄録
Flap coverage is the preferred treatment for finger pulp injuries with bone exposure. We herein report a case of small finger pulp reconstruction using an ulnar parametacarpal flap. A 26-year-old man had accidentally caught his finger in a bar bender during work, resulting in soft tissue loss of the small finger pulp. On the day of the injury, reconstruction was performed with an ulnar parametacarpal flap nourished mainly by the perforating branch of the ulnar palmar digital artery of the small finger. The patient’s small finger was fixed in a flexed position. Twelve days after finger pulp reconstruction, the flap was amputated, and the small finger was immobilized in extension for six days. His hand was allowed to be washed, and he began joint range-of-motion exercises 18 days after the injury. Seven months after flap amputation, satisfactory aesthetic and functional outcomes had been achieved.
(A) Photograph of the flap and the skin graft design. (B) Photograph of the donor site closure and flap fixation. The small finger was fixed in the flexed position (MCP joint in 30° flexion, PIP joint in 90° flexion, and DIP joint in 80° flexion). (C) The flap was elevated to the fascia layer. (D) Schematic illustration of the flap elevation. Two perforators from the ulnar palmar digital artery to the ulnar metacarpal region were ligated. One perforator from the ulnar palmar digital artery and another from the dorsal side flow into the flap.
