title: TWISTED DISTAL LATERAL ARM FLAP FOR IMMEDIATE RECONSTRUCTION OF THUMB AVULSION INJURY.
abstract: BACKGROUND
  Replantation is a complicated procedure in avulsion injuries in majority of the cases. When replantation of an avulsed thumb is not feasible, it is mandatory to find an appropriate reconstruction choice as soon as possible due to the importance of the thumb function in the dynamics of the handgrip.
  
  
  METHODS
  Three patients with skin avulsion injury underwent immediate reconstruction by twisted lateral arm flap in our department since 2004.
  
  
  RESULTS
  No infection, hematoma, partial or complete flap necrosis were observed after the procedure. All of the flaps healed without complications.
  
  
  CONCLUSIONS
  Although the gold standard in reconstruction of these trauma defects is the use of local skin flaps or distant inguinal flap, these reconstructive choices have multiple drawbacks such as the loss of sensibility and they are thicker. In thispaper we propose a modification of distally planned lateral arm flap design and a new technique of its spiral shaping for immediate thumb reconstruction.
authors.forename: P
authors.initials: P
authors.lastname: Hyza
authors.forename: L
authors.initials: L
authors.lastname: Streit
authors.forename: Z
authors.initials: Z
authors.lastname: Dvorak
authors.forename: G A G
authors.initials: GA
authors.lastname: Lombardo
authors.forename: T
authors.initials: T
authors.lastname: Mrazek
authors.forename: J
authors.initials: J
authors.lastname: Vesely
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery; D001132:Arm; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000601:surgery*