title: Optimizing functional upper extremity reconstruction-Simultaneous free anterolateral thigh flap and tendon transfers-A case report.
abstract: Composite upper extremity defects involving muscle-tendon units are amongst the most formidable reconstructive challenges and mandate functional restoration in addition to stable soft-tissue coverage. Here, the authors present a case of a composite defect involving the extensor muscle-tendon units of the forearm resulting from surgical resection of a recurrent Merkel cell cancer. Functional restoration was achieved via multiple tendon transfers followed by soft tissue coverage with a free anterolateral thigh (ALT) flap. No donor- or recipient-site complications were encountered and complete flap survival was noted. Following a 6-week period of immobilization, physical therapy and range of motion exercises were initiated. Excellent functional outcome and high patient satisfaction were noted at 8 weeks postoperatively. In summary, simultaneous tendon transfers and microsurgical tissue transfer may provide a potentially superior approach for upper extremity reconstruction in complex composite defects. © 2014 Wiley Periodicals, Inc. Microsurgery 37:71-74, 2017.
authors: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors: Sarah C
authors: SC
authors: Sorice
authors: Division of Plastic Surgery, Santa Clara Valley Medical Center, Santa Clara, CA.
authors: Barry
authors: B
authors: Press
authors: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors: Arash
authors: A
authors: Momeni
mesh_terms: D000368:Aged; D005260:Female; D005542:Forearm / Q000601:surgery*; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D013709:Tendon Transfer / Q000379:methods*; D013848:Thigh / Q000601:surgery*
keywords: ALT flap; microsurgery; plastic surgery; tendon transfer; upper extremity