The distal lateral arm flap for resurfacing of extensive defects of the digits.
The distal lateral arm flap (DLAF) was used to reconstruct six extensive defects of the digits: 2 degloving injuries of the thumb and 4 major skin losses of the fingers. Two adjacent fingers were involved in 1 patient. Flap size ranged from 3 x 7 cm to 9 x 14 cm. Four flaps were reinnervated using the posterior cutaneous nerve of the forearm. All flaps survived, though 1 showed marginal necrosis. Average follow-up was 53.4 months. Thumb opposition scored 5 according to Kapandji; finger ROM averaged 50.75%; pinch strength 72.5%. Protective sensation with touch localization was restored. Patient satisfaction for resurfaced digits averaged 8.9 on a 10-points visual analogic scale. All donor sites resulted in a painless scar with good patient satisfaction. The DLAF offers a thin, pliable skin ideal for digit reconstruction, with low rate of donor site morbidity and can be considered when toe-to-hand flap transfer is not advisable or refused by the patient.
Atzei
Andrea
A
Hand Surgery Unit, Policlinico G.B. Rossi, Azienda Ospedaliera-Universitaria, Piazzale L.A. Scuro 10, 37100 Verona, Italy. andrea.atze@univr.it
Pignatti
Marco
M
Udali
Giorgio
G
Cugola
Landino
L
Maranzano
Massimo
M
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D000714:Anastomosis, Surgical; D003646:Debridement; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries*