The ulnar digital artery of the thumb runs along the ulnar border of the thumb to supply the ulnar thumb pulp. It is the primary blood supply to the thumb ulnar surface and the dominant artery to the thumb tip in most individuals. It arises from the princeps pollicis artery or the superficial palmar arch.
The ulnar digital artery of the thumb is at risk in UCL (gamekeeper's thumb) repair, where the adductor pollicis aponeurosis and UCL reconstruction may compromise the vessel. In trigger thumb release and A1 pulley surgery, the radial digital artery is more at risk but the ulnar artery may be damaged in aberrant anatomy. Replantation of thumb amputations requires repair of both digital arteries for optimal perfusion.
Compromise of the ulnar digital artery of the thumb during gamekeeper's thumb surgical repair, producing thumb tip ischaemia requiring immediate vascular assessment and possible arterial repair.
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