Use of the venous flap for salvage of difficult ring avulsion injuries.
Ring avulsion can lead to soft tissue compromise resulting in eventual digit failure or restriction of motion. The authors present use of the venous flow through flap for simultaneous soft tissue and digital vessel reconstruction in severe ring avulsion injury. A retrospective review of ring avulsion injuries treated with transplantation of an arterialized (A-V-A) venous flap between 1999 and 2006 was conducted. Indications included digits which were debrided and required soft tissue and digital artery reconstruction. Eight venous flaps were transplanted for 3 Urbaniak class II and 5 Urbaniak class III ring avulsions. Average size of the venous flap was 6 cm(2). All flaps and digits survived without partial necrosis. The soft tissue envelope was supple in all cases. Total active motion (TAM) ranged from 160 to 210 degrees. The arterialized venous flow-through flap is a reliable solution for the complex ring avulsion injury which requires simultaneous soft tissue and digital vessel reconstruction.
Brooks
Darrell
D
Microsurgeon Buncke Clinic, California Pacific Medical Center, San Francisco, CA 94114, USA. dbrooks@microsurgeon.org
Buntic
Rudolf F
RF
Taylor
Chris
C
D000328:Adult; D005383:Finger Injuries / Q000209:etiology / Q000601:surgery*; D005385:Fingers / Q000098:blood supply; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012092:Replantation / Q000379:methods; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation; D055815:Young Adult