Radial forearm flaps for reconstruction in hand surgery

Abstract

Thirty-seven patients were treated using distally-based island radial forearm flaps. There were 31 men and six women. Reconstructed sites involved the dorsum of the hand (n = 17), the thumb (n = 11), the fingers (n = 5), the first web (n = 3), and the palm (n = 1). Sensory flaps were transferred in 15 cases, osteocutaneous flaps in six, and tendocutaneous flaps in eight. All the flaps survived. There were five donor-site complications, but no functional disturbances. Three patients had symptoms of cold intolerance. There were no radial fractures. In the six cases with osteocutaneous flaps, a mean of 2.6 months (range 2-3) was needed to obtain bony union. Among the eight cases with tendocutaneous flaps, postoperative tenolysis was required in two cases, and finally seven achieved a satisfactory outcome. The mean moving 2-point discrimination of the sensory flaps was 13 mm.

Functional reconstruction of bilateral injuries to the dorsum of hand using radial forearm tendocutaneous flaps

“…As tendon and skin defects are being repaired simultaneously, a tendocutaneous flap is the logical method of choice. A vascularised tendon graft has several advantages, including a reduced likelihood of developing tendon of the tendon, as it retains its vascularity after transfer and is transferred with its surrounding tissues containing the tendon sheath [4]. Singer et al [5] reported that in a comparative study of vascularised and non-vascularised tendon grafts in monkeys, the digits with vascularised tendons had significantly better simulated total active movement than digits with non-vascularised tendons.…”