Free Lateral Arm Flap for 1-Stage Reconstruction of Soft Tissue and Composite Defects of the Hand

Abstract

In this article, the long-term outcomes of hand defects after 1-stage reconstruction with lateral arm flap were retrospectively analyzed in a large series. Between the years 1990 and 2004, 118 traumatic hand defects were reconstructed using lateral arm fasciocutaneous flap (n = 104), lateral arm fascial flap (n = 6), and composite lateral arm flap (n = 8) in Chang Gung Memorial Hospital. There were 22 females and 96 males with an average age of 32.5 +/- 13.3 years. The mean follow-up period was 17 +/- 6.2 months. The overall success rate was 97.5%. The cosmetic outcomes were satisfactory and only 16.1% of the patients required debulking. The functional recovery of the hand contractures secondary to crush injury were generally associated with poor results. In the composite flap group, reconstruction of the extensor tendons with triceps tendon yielded limitation in tendon excursion and poor functional results. However, complete bone healing without complication was uniformly detected in all cases. Lateral arm fasciocutaneous flap endured secondary interventions well and no complications regarding wound healing was encountered.

Reverse Posterior Interosseous Flap in Childhood

“…The pedicled groin flap has been widely used for this aim, 21 but bulkiness and need for multistaged procedures are the major drawbacks of this flap. 22 Despite that there are also various free flaps, which mainly include scapular, 23 parascapular, 23 groin, 24 lateral arm, 25 and lateral thigh flaps, 26 in the surgical armamentarium, most of them are too bulky and require secondary debulking procedures and may not obtain a good texture and color harmony.…”

The Medial Sural Artery Perforator Flap: A Versatile Donor Site for Hand Reconstruction

“…14,15 One-stage composite tissue reconstruction by simultaneous transfer of various tissue components is also possible. 16,17 Free flap transfers have thus upgraded the standards for successful hand reconstruction. For hand defects, a thin, pliable fasciocutaneous flap is preferred.…”

Functional resurfacing of the palm: Flap selection based on defect analysis

“…Sensate free lateral arm flaps have shown improved sensory recovery compared with conventional fasciocutaneous or musculocutaneous flaps in the upper extremity. Ulusal et al 26 report protective sensation with a Two-Point-Discrimination greater than 15 mm their series.…”