The distally based posterior interosseous fasciocutaneous island flap in reconstruction of the hand in leprosy.
In leprosy a functionally useless hand can be the sequelae of resorption of the sensation-impaired thumb and fingers resulting from repeated trauma and infection. When this process shortens the thumb to the level of the proximal phalanx or metacarpal, the effect is to produce a relatively shallow first web space which together with the shortening, can prevent the most basic hand manoeuvre of a pincer or pinch grip. The reconstructive procedure commonly used in this situation is to widen and deepen the web space with a z-plasty combined with excision of the second metacarpal but the result can be inadequate. We have used the posterior interosseous fasciocutaneous island flap, both as a simple and a compound flap, to solve this challenging problem and we report here our experience with four patients.
Teo
T C
TC
Department of Plastic Surgery, Queen Victoria Hospital, West Sussex, UK.
Richard
B M
BM
D000328:Adult; D000368:Aged; D005260:Female; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007918:Leprosy / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D013933:Thumb / Q000601:surgery