title: Reconstruction of a postraumatic radial club hand with a free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure-A case report.
abstract: Radial club hand may be congenital or acquired; radial deviation of the hand is usually found, associated with palmar flexion-pronation and treatment of severe forms of radial club hand is often difficult. Here we present a case of reconstruction of a severe postraumatic radial club hand with a free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure in a 28-year-old man. The patient had a radial deviation of the wrist and right upper limb shortening as a result of an infected pseudarthrosis of the radius. This deformity was reconstructed with a free fibular osteoseptocutaneous flap associated to arthrodesis of the distal radioulnar joint and an ulnar resection osteotomy proximal to the arthrodesis in order to restore rotation of the forearm (Sauvé-Kapandji procedure). The flap fully survived and no complications were seen in the early postoperative period at both recipient and donor sites. Radius alignment was restored. At 5-month follow-up, the skeleton was healed. There was minimal osteopenia at the distal radial segment. Wrist extension was 48 degrees, flexion 24 degrees, and pronation-supination was 58-0-48 degrees, with full finger flexion. The patient could hold a 4 kg dumbbell with the elbow flexed without discomfort. His DASH score-Disabilities of the Arm, Shoulder, and Hand Questionnaire was 15.83. Combined free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure may be considered in severe forms of postraumatic radial club hand, however, further data are necessary. © 2016 Wiley Periodicals, Inc. Microsurgery 36:593-597, 2016.
authors.affiliation: Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar De São João, Faculty of Medicine, University of Porto, 4202-451, Porto, Portugal. ricardojmhorta@gmail.com.|Alameda Professor Hernâni Monteiro, Porto, Portugal. ricardojmhorta@gmail.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Horta
authors.affiliation: Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar De São João, Faculty of Medicine, University of Porto, 4202-451, Porto, Portugal.|Alameda Professor Hernâni Monteiro, Porto, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Nascimento
authors.affiliation: Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar De São João, Faculty of Medicine, University of Porto, 4202-451, Porto, Portugal.|Alameda Professor Hernâni Monteiro, Porto, Portugal.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Silva
authors.affiliation: Orthopedic Department, Centro Hospitalar São João, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Pinto
authors.affiliation: Orthopedic Department, Centro Hospitalar São João, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Negrão
authors.affiliation: Orthopedic Department, Centro Hospitalar São João, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: São-Simão
authors.affiliation: Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar De São João, Faculty of Medicine, University of Porto, 4202-451, Porto, Portugal.|Alameda Professor Hernâni Monteiro, Porto, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Carvalho
authors.affiliation: Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar De São João, Faculty of Medicine, University of Porto, 4202-451, Porto, Portugal.|Alameda Professor Hernâni Monteiro, Porto, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Santos Silva
authors.affiliation: Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar De São João, Faculty of Medicine, University of Porto, 4202-451, Porto, Portugal.|Alameda Professor Hernâni Monteiro, Porto, Portugal.
authors.forename: Jose
authors.initials: J
authors.lastname: Amarante
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000637:transplantation*; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy; D011542:Pseudarthrosis / Q000150:complications*; D011885:Radius Fractures / Q000150:complications*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014954:Wrist Injuries / Q000150:complications*
keywords: Sauve-Kapandji; procedure; radial club hand; reconstruction; vascularized free fibula