Ulnar Para-metacarpal Flap for Recurrence of Dupuytren's Disease with Skin Ulcer: A Case Report.

INTRODUCTION

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.

CASE REPORT: 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.

CONCLUSION

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.