TECHNIQUESThe Hypothenar Fat Pad Transposition Flap A Modified Surgical TechniqueChrysopoulo, Minas T. MD; Greenberg, Jeffrey A. MD; Kleinman, William B. MDAuthor Information 2766 Richardson St., Fitchburg, WI Address correspondence and reprint requests to Minas T. Chrysopoulo, M.D., PRMA 9635 Huebner Road, San Antonio, TX 78240. E-mail: [email protected]. Techniques in Hand and Upper Extremity Surgery: September 2006 - Volume 10 - Issue 3 - p 150-156 doi: 10.1097/01.bth.0000225004.56982.42 Buy Metrics Abstract The hypothenar fat pad flap has been shown to produce reliable clinical results for the treatment of recurrent carpal tunnel syndrome secondary to cicatricial tethering. The flap utilizes soft vascularized tissue that does not compromise hand function and is of sufficient size to provide median nerve coverage in the carpal tunnel. We describe technical modifications that facilitate improved, tension-free transposition of the pedicled fat pad flap. These modifications enable transfer of vascularized tissue and decrease iatrogenic damage to the important perforator vessels. The hypothenar fat pad transposition flap provides a reliable source of vascularized local tissue that can be used successfully as an adjunct to neurolysis for the treatment of recurrent idiopathic CTS secondary to perineural scarring. © 2006 Lippincott Williams & Wilkins, Inc.