Flap coverage of dorsum of hand associated with extensor tendons injuries: A completely vascularized single-stage reconstruction.
This study reports results in 12 patients treated with "completely vascularized single-stage approaches," so defined because skin, tendon, and nerve are transferred as a compound flap, and all are vascularized. A free dorsalis pedis cutaneotendinous flap was used in 7 patients, while a radial forearm cutaneotendinous island flap was transposed in 5 patients. A dorsalis pedis flap provides four vascularized extensor tendons (extensor digitorum comunis tendons), and the radial artery flap permits the inclusion of one completely vascularized tendon (palmaris longus) and two "strips" of vascularized tendons (flexor carpi radialis and brachioradialis). The flaps survived in all cases, and the transferred tendons were functioning well. The dorsalis pedis flap can be employed in the reconstruction of cutaneotendinous defects of the dorsum of the hand which require the use of three or four tendons grafts. We suggest the use of forearm cutaneotendinous flaps in cases of reconstruction of one or two extensor tendons. The "completely vascularized single-stage reconstruction" avoids prolonged hospitalization and results in a rapid restoration of near-normal function and appearance of the hand.
Adani
Roberto
R
Department of Orthopaedic Surgery, University of Modena and Reggio Emilia, Modena, Italy. adani.roberto@unimo.it
Marcoccio
Ignazio
I
Tarallo
Luigi
L
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006085:Graft Survival; D006230:Hand Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012039:Regional Blood Flow; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps / Q000098:blood supply*; D013708:Tendon Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology