title: Reconstruction of hand injuries with multiple metacarpal defects using free fibular osteoseptocutaneous flap.
abstract: Hand injuries with multiple metacarpal involvements often include midpalmar muscle, extensor tendon, and skin defects. Reconstruction method is decided according to the type and amount of structures to be restored. Bone reconstruction and resurfacing of the skin is regarded as priority, and restoration of tendon function and joint mobility can be left for further procedures. An ideal flap for such defects should provide bone for multiple metacarpal defects and a large enough skin paddle. Such flaps are few, and one of the most suitable of them all is the free fibular osteoseptocutaneous flap (free FOSCF). In this report, our experience with the use of free FOSCF for reconstruction of the mutilating hand injury in five patients with extensive skin integument and metacarpal involvement has been presented. Total lengths of fibular flaps were averagely 11 cm in length and were divided into averagely 2.4 segments. Average dimensions of the skin paddles were 7.75 × 8.75 cm. Although the nature of the devastating traumas limited the ultimate functional recovery; wound closure, stability, and various degrees of mobility were restored in all patients. In our experience, reconstruction with free FOSCF proved to be an effective tool in mutilating hand injuries with metacarpal involvement.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Ondokuz Mayis University, Samsun, Turkey. drtekinsimsek@hotmail.com
authors.forename: Tekin
authors.initials: T
authors.lastname: Simsek
authors.forename: M Sinan
authors.initials: MS
authors.lastname: Engin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demir
authors.forename: Volkan
authors.initials: V
authors.lastname: Tayfur
authors.forename: Lutfi
authors.initials: L
authors.lastname: Eroglu
mesh_terms: D000328:Adult; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000098:blood supply / Q000637:transplantation*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000293:injuries* / Q000601:surgery; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome