Fat grafting is commonly used to improve soft tissue contour and surface irregularities. More specifically, fat grafting has been well described to improve the look of aging hands. However, there are few reports of fat grafting to the hand for correcting the contour deformities that can occur after an ulnar nerve repair. In our patient, who underwent a successful repair of the ulnar nerve at the level of the elbow, atrophy of the intrinsic hand muscles was seen. Additionally, the patient had thenar wasting, which was most likely due to disuse atrophy. We describe the indications, anatomic planning, and surgical procedures that were used to reverse the wasted appearance of the hand. In this context, fat grafting has shown significant aesthetic improvement in the appearance of the hand. We conclude that fat injections to the hand are a valuable adjunctive treatment for the atrophied appearance of a hand following ulnar nerve injury and repair.
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