Fig. 1

A 40-year-old man with skin defects on the dorsal side of his right hand and thumb combined with defects of the thumb extensor tendon caused by a crush injury underwent wound repair with free thoracodorsal artery polyfoliate perforator flaps and tendon repair. A CTA image showing the thoracodorsal artery; B Two-dimensional CTA image showing the thoracodorsal artery; C Flap design simulation. (AA axillary artery, CSA circumflex scapular artery, TDA thoracodorsal artery, P1–P3 perforators); D The flap design was based on the perforator location detected by CTA and ultrasound; E Dissection of the flap showed perforators entering the flap; F The separated flap and multiple perforators entering the flap. The flap was modified to polyfoliate flaps; G After grafting repair of the tendon, the flaps were used to cover the wound in the hand; H The appearance immediately after covering