title: Restoration of basic hand function following devastating hand injuries using a microsurgically fabricated chimeric iliac osteocutaneous flap.
abstract: Reconstruction following devastating hand injuries, with amputations of the thumb plus multiple digits, is challenging. Double flap or combined flap transfers may be options in such cases. Between 2012 and 2014, 6 patients underwent hand reconstruction following devastating injuries with amputations of the thumb and multiple digits. Sensate anterolateral thigh free flaps and superficial circumflex iliac artery osteocutaneous flaps were microsurgically fabricated as sequential chimeric flaps. Basic hand function, including pulp-to-palm distance, pinch strength, sensation recovery and modified DASH scores, were evaluated. Anterolateral thigh flaps were used as "piggyback" flaps, and their size ranged from 8 cm × 16 cm to 10 cm × 25 cm. Cutaneous portions of superficial circumflex iliac artery osteocutaneous flaps ranged in size from 4 cm × 5 cm to 7 cm × 15 cm, and bone flap size ranged from 1 cm × 3 cm × 0.8 cm to 1 cm × 4 cm × 1 cm. All of the flaps survived uneventfully. All patients were able to perform basic hand functions after a median follow-up of 1.8 years. Microsurgically fabricated chimeric iliac osteocutaneous flaps may restore basic hand function to some extent. This procedure is an option worth considering for hand reconstruction following devastating injuries in carefully selected patients.
authors.affiliation: Institute of Orthopedic Trauma Surgery of the Chinese People's Liberation Army, 89th Hospital, Weifang, China. Electronic address: panzhaohui89yy@hotmail.com.
authors.forename: Zhao Hui
authors.initials: ZH
authors.lastname: Pan
authors.affiliation: Institute of Orthopedic Trauma Surgery of the Chinese People's Liberation Army, 89th Hospital, Weifang, China.
authors.forename: Ping Ping
authors.initials: PP
authors.lastname: Jiang
authors.affiliation: Institute of Orthopedic Trauma Surgery of the Chinese People's Liberation Army, 89th Hospital, Weifang, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Xue
authors.affiliation: Institute of Orthopedic Trauma Surgery of the Chinese People's Liberation Army, 89th Hospital, Weifang, China.
authors.forename: Hongfei
authors.initials: H
authors.lastname: Li
authors.affiliation: Institute of Orthopedic Trauma Surgery of the Chinese People's Liberation Army, 89th Hospital, Weifang, China.
authors.forename: Jian Li
authors.initials: JL
authors.lastname: Wang
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D058752:Free Tissue Flaps / Q000098:blood supply; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013848:Thigh / Q000601:surgery; D055815:Young Adult
keywords: Anterolateral thigh flap; Basic hand function; Devastating hand injury; Fabricated chimeric free flap; Superficial circumflex iliac artery osteocutaneous flap