Triple chimeric flap based on anterior tibial vessels for reconstruction of severe traumatic injuries of the hand with thumb loss

Plastic and Reconstructive Surgery
Yi Xin ZhangL Scott Levin

Abstract

Reconstruction of severe traumatic injuries of the hand with digit loss may require multiple procedures over a prolonged period. The authors present a clinical series of patients in which these types of injuries were reconstructed in a single operation. A chimeric flap based on the anterior tibial vessels is described. A total of three free tissue transfers included an anterior tibial flap, a dorsalis pedis flap, and a great toe wrap-around flap. These triple flaps were transferred to resurface the defects of the mutilated hand, which was involved in the thumb, first web space, volar palm, thenar eminence, or radial aspect of wrist. The cumulative size of the defects ranged from 9 x 11 cm to 12 x 18 cm. From 2002 to 2007, six patients with multiple defects of the hand and thumb underwent reconstruction using the described technique. The donor sites were covered by means of split-thickness skin grafting. All flaps survived and patients were satisfied with the functional and aesthetic outcome postoperatively at 6 to 12 months' follow-up. The average improvement of thumb opposition was 4.8 on the Kapandji scale. Sensory recovery of the thumb tip of S3 was achieved. There were no major donor-site complications. A chimeric flap base...Continue Reading

References

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Citations

Jul 6, 2014·Clinics in Plastic Surgery·Zeng Tao Wang, Wen Hai Sun
Oct 29, 2011·Clinics in Plastic Surgery·Wee-Leon Lam, Fu-Chan Wei
Sep 2, 2015·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Jeong Tae KimAli M Ghanem
Jun 11, 2019·Plastic and Reconstructive Surgery·Francisco Del Piñal
Nov 18, 2018·Journal of Orthopaedic Surgery and Research·Tomoyuki KuroiwaAtsushi Okawa
Aug 29, 2019·Plastic and Reconstructive Surgery·Francisco Del Piñal

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