title: Arterial vascularization of the flexor digitorum superficialis synovial flap. An anatomical study.
abstract: Among the various techniques proposed to protect the median nerve from scarring and to provide it with a vascular supply, the synovial flap represents a simple and effective method. The flap is taken from the flexor tendons sheath and results in a thin and richly vascularized tissue that will act as a barrier to scarring and provide neovascularization to improve nerve regeneration and gliding. The aim of this study was to evaluate the arterial vascularization of this flap to assess its reliability. An anatomic study was carried out on 24 fresh upper limbs infused with colored and radiopaque solutions before or after flap elevation. Anatomical findings showed the synovial flap to be supplied by a consistent vascular pedicle arising from the ulnar artery 2 to 5 centimeters proximal to the pisiform bone and running between the flexor tendons of the ring and little fingers. The synovial flap is known to be a simple and effective method for protecting the median nerve. The present study shows that its consistent vascularization makes it a reliable technique. We believe this procedure is relevant for the treatment of recurring carpal tunnel syndrome.
authors.affiliation: Service de chirurgie plastique-brûlés-main, centre F.X.-Michelet, groupe hospitalier Pellegrin, 33076 Bordeaux, France. Electronic address: philippe.pelissier@chu-bordeaux.fr.
authors.forename: P
authors.initials: P
authors.lastname: Pelissier
authors.affiliation: Service de chirurgie plastique-brûlés-main, centre F.X.-Michelet, groupe hospitalier Pellegrin, 33076 Bordeaux, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Alet
authors.affiliation: Orthopôle, 53 bis, avenue Maryse-Bastié, 33520 Bruges, France.
authors.forename: A
authors.initials: A
authors.lastname: Morchikh
authors.affiliation: Service de chirurgie plastique-brûlés-main, centre F.X.-Michelet, groupe hospitalier Pellegrin, 33076 Bordeaux, France.
authors.forename: H
authors.initials: H
authors.lastname: Choughri
authors.affiliation: Service de chirurgie plastique-brûlés-main, centre F.X.-Michelet, groupe hospitalier Pellegrin, 33076 Bordeaux, France; Laboratoire d'anatomie, université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux, France.
authors.forename: V
authors.initials: V
authors.lastname: Casoli
mesh_terms: D000328:Adult; D001158:Arteries; D002102:Cadaver; D005385:Fingers / Q000601:surgery*; D006801:Humans; D018482:Muscle, Skeletal / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013710:Tendons / Q000098:blood supply* / Q000601:surgery*
keywords: Carpal tunnel syndrome; Flap; Lambeau; Recurrence; Récidive; Syndrome du canal carpien; Synovial