Elbow parametakarpalny flap for defects of the fingers
first elbow parametakarpalny flapfor defects of the fingers described by J. Bakhach et al.in 1995 year.
Inbox tissue.The skin, subcutaneous fat, descending branch of the back of the ulnar artery, vein rear skin.
blood supply.Due to the descending branch of the back of the ulnar artery, which runs from the ulnar artery approximately 3.5 cm proximal to the pisiform bone.Blood flow in the flap is carried by retrograde own palmar finger artery V finger across the anastomosis on the back of the hand in the neck V metacarpal bone (here is a point of rotation), then back to the medial cutaneous branch of the descending branch of the ulnar artery back.The latter goes into the ascending branch, and is also connected to the ulnar artery after anastomosis in the space between the styloid process of the ulna bone and pisiform.Thus, the maximum len
anatomy of vascular pedicle.tissue unit around the anastomosis own palmar finger artery V finger to the back of the medial cutaneous arterial branches in the neck V metacarpal bone.
parametakarpalny ulnar flap finger defects.Dimensions.Width - the zone fence flap from the elbow to the edge of the brush III metacarpal bone;length - from the neck V metacarpal bone to the pisiform bone.
Indications.Defects in the palm and the back surfaces of all V pin and the proximal phalanx IV finger.
Layout flap surgical technique.After marking (the boundaries described above) is performed on the medial edge of the cut, including in the abductor aponeurosis flap.Leg not need visualization;it allocates a block with aponeurosis, which is raised and otseparovyvayut of the metacarpal bone.At the proximal edge of the flap the arterial branch ligated legs at the back extensor wrist crease.Rotating flap in the neck V metacarpal bone, remove the harness, make sure its blood supply is transferred into the defect.
parametakarpalny ulnar flap: 1 - ulnar artery;2 - anastomosis;3 - the ascending branch of the back of the ulnar artery;4 - descending branch of the back of the ulnar artery;5 - own palmar digital artery V finger;6 - medial dorsal cutaneous branch of the arterial
Features release flap.It should be especially careful to allocate the leg flap in the neck V metacarpal bone, considering the risk of damage to the anastomosis with the ulnar palmar digital artery V finger.You do not need to strive to distinguish itself artery since the last release unit with aponeurosis.It is important to include 1 cm of the skin in the area of the radial edge V metacarpal bone.
Dangers.Damage to the axial artery re cool feet.