Use of latissimus dorsi perforator flap to facilitate simultaneous great toe-to-thumb transfer in hand salvage.
Severe crushing and degloving injury of the hand often involves multiple tissue structures requiring several stages of reconstructions. This is more challenging when tissue defect and loss of thumb co-exist, requiring vascularised tissue transfer and toe-to-thumb reconstruction in a hand that has severely compromised vascularity. The management variables to be considered include the use of pedicled or free flap, simultaneous or staged procedures, consideration for early rehabilitation and flap selection to facilitate simultaneous free tissue transfers without further jeopardy to the vascularity of the hand. We illustrate these considerations in a case we have managed with simultaneous application of a latissimus dorsi perforator flap and great toe-to-thumb transfer.
Department of Plastic and Reconstructive Surgery, School of Medicine, Hanyang University, 17 Haengdang-Dong, 133-792 Seongdong-Gu, Seoul, Republic of Korea.
Youn Hwan
YH
Kim
Siew-Weng
SW
Ng
Seung Ki
SK
Youn
Chang Yeon
CY
Kim
Jeong Tae
JT
Kim
D005383:Finger Injuries / Q000601:surgery*; D018409:Foot Injuries / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery; D013710:Tendons / Q000601:surgery*; D013933:Thumb / Q000293:injuries* / Q000601:surgery; D014034:Toes / Q000293:injuries* / Q000601:surgery