Functional and esthetic reconstruction of a mutilated hand using multiple toe transfers and iliac osteocutaneous flap: A case report

Wei, Fu‐Chan; Seah, Chee-Seng; Chen, Hung-Chi; Chuang, Cheng Keng

doi:10.1002/micr.1920140607

Cited by 14 publications

(8 citation statements)

References 8 publications

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“…According to some authors, harvesting of longer part of the second metatarsal bone does not impair function of the foot (4, 7). Thus, it seems to be a better solution than ocgf (14,44,45).…”

Section: Resultsmentioning

confidence: 98%

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Procedures of Soft Tissues Reconstructions of the Hand Preceding Toe-to-Hand Transfers

Molski¹

2009

Polish Journal of Surgery

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Extensive defects, damage and resulting scarring of tissues frequently accompany amputation of fingers. Better functional result of rebuilt thumb using toe can be achieved when soft tissue reconstruction is performed in first stage. The aim of the study was to present current methods of soft tissue reconstruction and evaluation of their results in patients after thumb rebuilt with toe. Material and methods. In 18 males (aged 15-45, mean 25) of 75 patients after hand trauma and thumb reconstruction by toe-to-hand transfer, rebuilding of soft tissues of the hand was also required. This operation, as the first stage of reconstruction, was performed in 16 cases and in 2 cases both stages (soft tissue and thumb reconstructions) were conducted simultaneously during one procedure. Various methods of soft tissue reconstruction on hand and thumb were used. Between 1986 and 1996 pedicled groin flap was most frequently performed (8 cases). After 2000 adipocutaneous flap based on perforators of radial artery located in distal forearm was a dominating method of soft tissues reconstruction (5 cases). Thumb was rebuilt with the second toe most frequently (13 cases). Results. Despite observed complications in flap healing, sufficient coverage was achieved to conduct toe-to-thumb transfer in all cases. Osteocutaneous groin flap did not bring expected advantages in bone reconstruction within the first ray of the hand. The time interval from injury to soft tissue reconstruction (0-27 months) and the time from soft tissue reconstruction to thumb restoration (0-12 years) had no influence on final result of treatment. Conclusions. Pedicled adipocutaneous groin flap is still one of the basic methods of treating extensive posttraumatic defects of the hand soft tissues. In cases of minor tissue loss causing adduction contracture of the first metacarpal bone, particularly after explosive injuries, distally pedicled adipocutaneous flap supplied by radial artery perforators is a simple and effective therapeutic option. This method has two significant advantages in comparison to groin flap: fixation of the hand in uncomfortable position is not required and reconstruction can be completed in one-stage. Further recognition and understanding of the flap tissues healing process require careful clinical observations.

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Section: Resultsmentioning

confidence: 98%

“…distal to MP I joint). Only minor areas of the hand and transferred tissues from tions (44,45). Vascularization of iliac crest in ocgf originates from superficial circumflex iliac artery which is an axial vessel of groin flap.…”

Section: Resultsmentioning

confidence: 99%

Procedures of Soft Tissues Reconstructions of the Hand Preceding Toe-to-Hand Transfers

Molski¹

2009

Polish Journal of Surgery

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“…Free aps are associated with more number of postoperative complications in spite of their success in these particular patients [20,21,22 ] .Coverage of amputated stump of the thumb or multiple ngers by pedicled ap is a well-established entity . The pedicled ap [23,24] preserves the recipient vessels for second-stage to transfer besides providing stable soft tissue cover and preventing contractures of ngers. Complex circumferential degloving injury to the multiple digits almost always requires a pedicled ap .…”

Section: Discussionmentioning

confidence: 99%

Versatility of Paraumbilical Perforator Flap for Upper Limb Reconstruction

Mishra

2020

ijsr

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Background Microvascular flap and groin flap are the most commonly used flaps for upper limb reconstruction. Microvascular flap can not be done in certain situations and groin flap is not convenient for coverage of forearm defect and elbow defect. Paraumbilical perforator (pup) flaps can provide a large amount of tissue for coverage of forearm , elbow defects and mitigates the side effects of groin flap. Material and method A retrospective study was conducted for reconstruction of soft tissue defects from finger tip to elbow between January 2016 to December 2019 with PUP flaps .Demographic data, size of the defect, etiology ,flap design and flap complication were analysed . Result The age of the patients ranged from 12 years to 56 year with mean age of 29.85 years and SD = 11.073. Male to female ratio was 1.5 : 1 (M=12 , F= 8). Size of the defect varied between 20 cm2 to 288cm2 with mean of 88.1 cm 2 and SD = 29.69 .No of cases with flap dimension < 100 cm 2 (n= 13), and > 100 cm2 (n= 7) . Aetiology of injury included vehicular accidents in 10 patients, machine injury in 2 patients, electrical burns in 6 patients post snake bite ulcer 2 patients. The location of the defect included hands, forearm and the elbow, and fingers.Flap was directed Superolaterally in 18 patients , inferolaterally in one case , and combined medially and laterally in one case. There was no case of complete flap failure. Conclusion Paraumbilical perforator flap can be a safe and reliable option for soft tissue reconstruction in varied areas of upper limb.

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“…27 Coverage of amputated stump of the thumb or multiple fingers by pedicled flap is a well-established entity. 28,29 The pedicled flap preserves the recipient vessels for second-stage toe transfer besides providing stable soft tissue cover and preventing contractures of fingers.…”

Section: Discussionmentioning

confidence: 99%

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery

Naalla

Dawar

et al. 2018

J Hand Microsurg

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Functional and esthetic reconstruction of a mutilated hand using multiple toe transfers and iliac osteocutaneous flap: A case report

Cited by 14 publications

References 8 publications

Procedures of Soft Tissues Reconstructions of the Hand Preceding Toe-to-Hand Transfers

Procedures of Soft Tissues Reconstructions of the Hand Preceding Toe-to-Hand Transfers

Versatility of Paraumbilical Perforator Flap for Upper Limb Reconstruction

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery

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