Small Finger Pulp Reconstruction with an Ulnar Parametacarpal Flap

Flap coverage is the preferred treatment for finger pulp injuries with bone exposure. We herein report a case of small finger pulp reconstruction using an ulnar parametacarpal flap. A 26-year-old man had accidentally caught his finger in a bar bender during work, resulting in soft tissue loss of the small finger pulp. On the day of the injury, reconstruction was performed with an ulnar parametacarpal flap nourished mainly by the perforating branch of the ulnar palmar digital artery of the small finger. The patient's small finger was fixed in a flexed position. Twelve days after finger pulp reconstruction, the flap was amputated, and the small finger was immobilized in extension for six days. His hand was allowed to be washed, and he began joint range-of-motion exercises 18 days after the injury. Seven months after flap amputation, satisfactory aesthetic and functional outcomes had been achieved.