End-to-side innervated sensate radial forearm flap in the hand: A 5-year follow-up

Lucchina, Stefano; Fusetti, Cesare; Lazzaro, Lara; Nistor, Alexandru; Guidi, Marco

doi:10.1016/j.hansur.2019.03.005

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…Sacrifice of this nerve does not lead to a significant sensory deficit and has never been emphasized by our patients. If there is a need for a greater degree of protective sensation return such as in palmar reconstructions, sensate flap can be achieved by the same nerve 20 .…”

Section: Discussionmentioning

confidence: 99%

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

et al. 2023

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Background/Aim. Radial artery perforator flap (RAPF) as a type of fasciocutaneous or adipofascial reverse pedicle flap, proved to be a versatile flap for reconstruction of small and moderate size soft tissue defects of the forearm, wrist, and hand. It provides suitable skin coverage with elastic subcutaneous tissue to protect exposed or damaged functional structures. The aim of this study is to summarize and analyse the results of the treatment of our patients with upper extremity soft tissue defects caused by trauma, infection, burn or tumour removal which were reconstructed with RAPF. Methods. This retrospective study includes 20 consecutive patients with skin and soft tissue defects of the hand and wrist, treated in the University Clinical Centre of Vojvodina from 2012 to 2022. Design of the flaps and length of the pedicles were determined by the recipient site. Tourniquet induced exsanguination was used during surgery for better visualization. The flaps were elevated and placed at the site of the defect. Patient and flaps? data were summarized upon their collection. Results. Distally based radial artery fasciocutaneous perforator flaps were used in all of the cases. The average age of the patients was 48 years, mostly males (64%). Defects were most often localized on the dorsal part of the hand (60%) and wrist (20%). The most common indications for surgery were trauma (45%) and tumour resection (25%). A satisfactory coverage of the defect was achieved in all 20 patients with no flap loss. Venous congestion was noted in 4 patients (20%) which resulted in partial necrosis of the flap in 3 patients (15%). Wound healing was achieved upon conservative treatment by secondary intention in two patients and with secondary suture in the last one. A surgical site infection occurred in 2 patients (10%) which withdrew after proper local and systemic therapy. Conclusion. Radial artery perforator flap proved to be a workhorse flap for soft tissue reconstruction of the upper limb. This surgical solution led to an excellent functional and aesthetic outcome in the majority of patients. Complex surgical procedures could be done simultaneously, together with reconstruction of tendons, joints, or fracture stabilisation. The reliability and safety of this flaps is confirmed through our clinical data.

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Section: Discussionmentioning

confidence: 99%

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

et al. 2023

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“…Vascular reliability and technical reproducibility are two main criteria for selecting flaps [4]. To guarantee the best functional outcomes, it is preferable to use a sensitive flap [5][6].…”

Section: Introductionmentioning

confidence: 99%

Pedicled flap from the first dorsal branch of the proper palmar digital artery of the fingers: An anatomy study

Wolf-Mandroux

Detammæcker

Almeida

et al. 2020

Hand Surgery and Rehabilitation

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Functional reconstructions using only ulnar nerve and ulnar nerve-innervated muscles for traumatic musculocutaneous, median and radial nerve palsies

et al. 2021

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A 20-year-old right-handed fisherman experienced a severe injury in a high-energy traffic accident. These injuries included a shaft fracture of the right humerus, open comminuted fracture of the right forearm and multiple peripheral nerve palsies involving the musculocutaneous, median and radial nerves. Six months after the initial treatment, the patient was referred to our hand surgeons for further treatment. Several operations for functional reconstruction using only the ulnar nerve and ulnar nerve-innervated muscles were performed: the main procedures included a partial ulnar nerve transfer for elbow flexion, flexor carpi ulnaris transfer for reconstruction of wrist and finger extension and opponensplasty using the abductor digiti minimi. Three years after the initial injury, the patient had relatively good function including elbow flexion and stable side pinch and grasp. Functional reconstruction using a combination of the ulnar nerve and ulnar nerve-innervated muscles may be useful in specific cases involving multiple peripheral nerve injuries.

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End-to-side innervated sensate radial forearm flap in the hand: A 5-year follow-up

Cited by 5 publications

References 8 publications

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

Versatile clinical application of radial artery perforator flap for hand and wrist reconstruction

Pedicled flap from the first dorsal branch of the proper palmar digital artery of the fingers: An anatomy study

Functional reconstructions using only ulnar nerve and ulnar nerve-innervated muscles for traumatic musculocutaneous, median and radial nerve palsies

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