The surgical anatomy of the dorsal carpal branch of the ulnar artery: basis for a neurovascular dorso-ulnar pedicled flap

Abstract

In order to design a neurovascular flap from the dorso-ulnar aspect of the midhand for pedicled transfer to adjacent or distant locations, the surgical anatomy of the dorsal carpal branch of the ulnar artery (DCBUA) was studied in 12 cadavers. The DCBUA was identified in all specimens. It originates from the ulnar artery 1.6 to 4.4 centimeters proximal to the ulnar styloid, passing deep to the flexor carpi ulnaris tendon, and spirals superficially to the extensor retinaculum around the ulnar border of the wrist. Its terminal branches supply an undetermined area of skin overlying the ulnar metacarpals and the ulnar hypothenar region, either by direct cutaneous supply (3/12 specimens) or by septo-cutaneous perforators (8/12 specimens). The DCBUA is closely related to the dorsal sensory branch of the ulnar nerve, with which it supplies a common neurovascular territory.

Distal radial and ulnar arteries perforator‐based adipofascial flaps for covering hand traumatic defects

“…3,5 The principle of flap vascular supply via perforators can be applied in the radial-forearm flap.…”

“…1 With the advent of perforator flap surgery reduction of donor site morbidity has been made possible, improving the functional and esthetic result of the coverage operation. [6][7][8] The vascular supply 2,3 of the flap arises from the ulnar artery. The main trunk of the pedicle is called ulnodorsal artery, arising from the ulnar artery 3-5 cm proximal to the pisiform.…”

“…The reversed ulnar forearm flap described by Lovie is a septocutaneous flap [1][2][3][4][5] based on the septocutaneous perforators of the ulnar artery, but it can also be harvested as a fascial flap. 2 The use of the fascial flap is indicated in patients with soft tissue defects of the hand.…”

Anatomie chirurgicale de la face dorsale de la main et du poignet

“…Oppikofer et al [21] et Casoli et al [6] ont décrit un lambeau neurovasculaire fondé sur cette artère et le nerf correspondant. De la même façon, Coskunfirat et al [7] ont décrit un lambeau neuro-vasculaire fondé sur l'artère radiale.…”

Clinical Application of Distal Ulnar Artery Perforator Flap in Hand Trauma

“…The main trunk of the distal ulnar artery perforator flap originates from the ulnar artery at a distance of 3 to 5 cm proximal to the pisiform. Detailed anatomy of the dorsal ulnar artery has been introduced by Oppikofer et al 1 After passing under flexor carpi ulnaris (FCU), the main trunk of the perforator divides into three branches:…”