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Anatomical study and clinical relevance of the flexor superficialis synovial flap: an assessment of 31 hand dissections

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Abstract

Purpose

The authors present an anatomical study of the flexor digitorum superficialis synovial flap and its clinical application for palmar soft tissue defects in hand trauma.

Methods

Green latex was injected into the brachial artery of thirty-one human upper limbs from corpses donated to science. Anatomical features of this pedicled flap were assessed: arterial vascularization, dimensions and covering surface.

Results

The anatomical support of this flap is the synovial tissue of the flexor tendons, and particularly the superficial layer of the synovial system, covering the flexor digitorum superficialis (FDS) tendons in the forearm. It is vascularized by four different arteries: a constant collateral branch of the ulnar artery, and three inconstant arterial supports: from collateral branches of the superficial palmar arch, from the radial artery, and from the vasa nervorum of the median nerve. The flap is harvested from proximal to distal on the ulnar pedicle to cover the palmar soft tissue defects of the hand. A clinical application of this synovial flap is presented via a case report for covering a palmar skin defect secondary to a hand injury.

Conclusions

The synovial flap contains a constant ulnar pedicle and could be considered a useful alternative to cover palmar soft tissue defects.

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Acknowledgments

The authors are grateful to Ludovic Lievain who was most helpful with the iconography, to Andy Auckbur, who provided advice regarding the English of the original manuscript, and to Richard Medeiros, Rouen University Hospital Medical Editor, for editing the final version of the manuscript.

Conflict of interest

The authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Hand Surgery Unit, Department of Plastic Surgery, Rouen University Hospital-Charles Nicolle, Rouen, France

    Abdelghani Aktouf, Isabelle Auquit-Auckbur & Pierre-Yves Milliez

  2. Department of Orthopedics and Traumatology, Rouen University Hospital-Charles Nicolle, Rouen, France

    Nasser Mebtouche, Frédéric Mouilhade, Yves-Pierre Le Moulec & Fabrice Duparc

  3. Laboratory of Anatomy, Faculty of Medicine and Pharmacy, Rouen University, Rouen, France

    Fabrice Duparc

Authors
  1. Abdelghani Aktouf
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  2. Isabelle Auquit-Auckbur
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  3. Nasser Mebtouche
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  4. Frédéric Mouilhade
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  5. Yves-Pierre Le Moulec
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  6. Pierre-Yves Milliez
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  7. Fabrice Duparc
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Corresponding author

Correspondence to Isabelle Auquit-Auckbur.

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Aktouf, A., Auquit-Auckbur, I., Mebtouche, N. et al. Anatomical study and clinical relevance of the flexor superficialis synovial flap: an assessment of 31 hand dissections. Surg Radiol Anat 34, 493–498 (2012). https://doi.org/10.1007/s00276-012-0942-y

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  • DOI: https://doi.org/10.1007/s00276-012-0942-y

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