The distally based ulnar artery island flap in hand reconstruction.

The distally based ulnar artery island flap is a highly versatile flap for hand reconstruction. It fulfils all the necessary criteria required for a flap to the hand providing thin pliable hairless skin. It can be used as a composite flap including tendon and bone and provides an ideal tunnel for tendons to glide in. It can be used as a fasciocutaneous flap or as a fascial flap and can easily be rotated to the dorsum of the hand by opening Guyon's canal. The palm or dorsum of the hand and even the fingertips can be reached easily. A superficial venous anastomosis should be made if marked venous congestion is noted intraoperatively. Six cases utilizing a distally based ulnar island flap in hand reconstruction are presented.