title: Pedicled hypothenar perforator flap: Indications and clinical application.
abstract: OBJECTIVE
  Soft-tissue defects of the palm and the palmar aspect of the fifth finger are a constant problem in reconstructive hand surgery. We present a possible approach to planning and harvesting pedicled hypothenar perforator flaps for the reconstruction of such defects.
  
  
  METHODS
  A hypothenar perforator flap was used to reconstruct a soft-tissue defect on the ulnar aspect of the palm and the palmar aspect of the fifth finger of 17 patients. The defects were located over the proximal phalanx of the fifth finger (n = 9), the palm (n = 5), and across both areas (n = 3). The size of the defects was up to 7.9 cm(2).
  
  
  RESULTS
  Eleven of the flaps healed primarily, out of which partial flap necrosis was observed in six. Four of these six flaps required operative revision, including debridement and delayed primary wound closure, while two healed secondarily. After an average of 26.6 days (range 21-45 days), all 17 patients achieved complete functional recovery. Despite the complications described, all the primary defects remained covered.
  
  
  CONCLUSIONS
  The pedicled hypothenar perforator flap is an option for reconstruction of ulnar-sided, soft-tissue defects of the palm and little finger. The flap is thin and the donor-site morbidity is low. Hand surgeons may wish to consider this flap when presented with soft-tissue defects in this area.
authors.affiliation: Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria. Electronic address: stefan.winsauer@lkhf.at.
authors.forename: S
authors.initials: S
authors.lastname: Winsauer
authors.affiliation: Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Gardetto
authors.affiliation: Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Kompatscher
mesh_terms: D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis / Q000601:surgery*; D006230:Hand Injuries / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D061525:Perforator Flap / Q000009:adverse effects / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Finger reconstruction; Hypothenar flap; Palmar defect; Perforator flap