title: Osteofasciocutaneous flap based on the dorsal ulnar artery. A new option for reconstruction of composite hand defects.
abstract: Since the initial description of the dorsal ulnar artery fasciocutaneous flap by Becker and Gilbert in 1988 many modifications have been introduced to allow more versatility to the flap. The authors describe the dissection technique of an osteofasciocutaneous flap based on the dorsal ulnar artery and present a clinical case where this flap has been used to reconstruct a bone defect of the fifth metacarpal. Up to one third of the outer cortex of a long bone is supplied by the periosteal arterioles. This permits the inclusion of a small amount of ulnar cortical bone in the dorsal ulnar flap to reconstruct compound defects of the hand. The essential precaution is not to disrupt the continuity formed by the posterior border of the ulna, the periosteum, bony attachments of the flexor carpi ulnaris and extensor carpi ulnaris muscles, fascia and the skin. This flap allows the transposition of optimal soft tissue coverage to the hand with vascularised bone preserving the main arteries to the hand.
authors.affiliation: Department of Plastic and Reconstructive and Aesthetic Surgery, Faculty of Medicine, São João Medical School Hospital, Porto University, Alameda Hernâni Monteiro, 4202-451 Porto, Portugal. mchoupina@sapo.pt
authors.forename: Miguel
authors.initials: M
authors.lastname: Choupina
authors.forename: Edgardo
authors.initials: E
authors.lastname: Malheiro
authors.forename: Isabel
authors.initials: I
authors.lastname: Guimarães
authors.forename: Carlos
authors.initials: C
authors.lastname: Pinho
authors.forename: Pedro
authors.initials: P
authors.lastname: Silva
authors.forename: Pedro
authors.initials: P
authors.lastname: Ferreira
authors.forename: Jorge
authors.initials: J
authors.lastname: Reis
authors.forename: José
authors.initials: J
authors.lastname: Amarante
mesh_terms: D000328:Adult; D001753:Blast Injuries; D016025:Bone Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000293:injuries*; D013524:Surgical Flaps; D014457:Ulna / Q000637:transplantation*; D014945:Wound Healing