Ulnar Para-metacarpal Flap for Recurrence of Dupuytren's Disease with Skin Ulcer: A Case Report.
BACKGROUND
In a patient with recurrent Dupuytren's disease, we performed dermofasciectomy including the diseased skin and soft tissue, and covered the soft tissue defect using an ulnar parametacarpal flap.


METHODS
A 65-year-old man had undergone invasive aponeurectomy for Dupuytren's contracture of the right 5th finger 3 years before, but showed recurrence about 1 year after surgery. Since a skin ulcer was noted at the site of recurrence, dermofasciectomy including the scarred skin was performed on the palmar side of the 5th finger, and the skin defect was covered with an ulnar parametacarpal flap. No recurrence has been noted for the 6 months since the surgery.


CONCLUSIONS
The ulnar parametacarpal flap, in which the vascular pedicle is easy to identify, is useful for covering a skin defect on the palmar side of the 5th finger if used as an island flap. However, a disadvantage of this flap is that it is likely to develop congestion due to poor venous return.
Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, 410-2295 Japan.
Yoichi
Y
Sugiyama
Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, 410-2295 Japan.
Kiyohito
K
Naito
Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, 410-2295 Japan.
Yuka
Y
Igeta
Department of Orthopaedics, Juntendo University School of Medicine. Japan.
Kazuo
K
Kaneko
Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, 410-2295 Japan.
Osamu
O
Obayashi
Dermofasciectomy; Recurrence of Dupuytren’s disease; Ulnar parametacarpal flap