Research Article| Volume 65, ISSUE 8, P1076-1082, August 2012

Perforator anatomy of the ulnar forearm fasciocutaneous flap

  • Jon A. Mathy
    Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand
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  • Zachary Moaveni
    Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand
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  • Swee T. Tan
    Corresponding author. Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High Street, Lower Hutt, New Zealand. Tel.: +64 4 587 2506; fax: +64 4 587 2510.
    Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand

    Gillies McIndoe Research Institute, Wellington, New Zealand

    Wellington School of Medicine & Health Sciences, University of Otago, Wellington, New Zealand
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Published:April 16, 2012DOI:


      The ulnar forearm fasciocutaneous flap (UFFF) is a favourable alternative to the radial forearm flap when thin and pliable tissue is required. The precise anatomy of the cutaneous perforators of UFFF has not been previously reported.
      The position of cutaneous perforators >0.5 mm was recorded while raising 52 consecutive free UFFFs in 51 patients at our Centre.
      Three (6%) UFFFs in two patients demonstrated direct cutaneous supply through a superficial ulnar artery, a known anatomic variance. There was no cutaneous perforator >0.5 mm in one flap. Among the remaining 48 dissections, an average of 3 (range, 1–6) cutaneous perforators were identified. Ninety-four percent of these forearms demonstrated at least one perforator >0.5 mm within 3 cm, and all had at least one perforator within 6 cm of the midpoint of the forearm. Proximal perforators were more likely to be musculo-cutaneous through the edge of flexor carpi ulnaris or flexor digitorum superficialis, while mid- to distal perforators were septo-cutaneous.
      UFFF skin paddle designed to overlie an area within 3 cm of the midpoint between the medial epicondyle and the pisiform is most likely to include at least one cutaneous perforator from the ulnar artery, without a need for intra-operative skin island adjustment. This novel anatomic finding and other practical generalisations are discussed to facilitate successful elevation of UFFF.


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