Restoration of basic hand function following devastating hand injuries using a microsurgically fabricated chimeric iliac osteocutaneous flap.
Reconstruction following devastating hand injuries, with amputations of the thumb plus multiple digits, is challenging. Double flap or combined flap transfers may be options in such cases. Between 2012 and 2014, 6 patients underwent hand reconstruction following devastating injuries with amputations of the thumb and multiple digits. Sensate anterolateral thigh free flaps and superficial circumflex iliac artery osteocutaneous flaps were microsurgically fabricated as sequential chimeric flaps. Basic hand function, including pulp-to-palm distance, pinch strength, sensation recovery and modified DASH scores, were evaluated. Anterolateral thigh flaps were used as "piggyback" flaps, and their size ranged from 8 cm × 16 cm to 10 cm × 25 cm. Cutaneous portions of superficial circumflex iliac artery osteocutaneous flaps ranged in size from 4 cm × 5 cm to 7 cm × 15 cm, and bone flap size ranged from 1 cm × 3 cm × 0.8 cm to 1 cm × 4 cm × 1 cm. All of the flaps survived uneventfully. All patients were able to perform basic hand functions after a median follow-up of 1.8 years. Microsurgically fabricated chimeric iliac osteocutaneous flaps may restore basic hand function to some extent. This procedure is an option worth considering for hand reconstruction following devastating injuries in carefully selected patients.
['Pan|Zhao Hui|ZH|', 'Jiang|Ping Ping|PP|', 'Xue|Shan|S|', 'Li|Hongfei|H|', 'Wang|Jian Li|JL|']
D000328:Adult D000673:Amputation, Traumatic D005260:Female D005383:Finger Injuries D058752:Free Tissue Flaps D006230:Hand Injuries D006801:Humans D007083:Iliac Artery D008297:Male D008875:Middle Aged D019651:Reconstructive Surgical Procedures D020127:Recovery of Function D012189:Retrospective Studies D013848:Thigh D055815:Young Adult
Basic hand function Devastating hand injury Superficial circumflex iliac artery osteocutaneous flap Anterolateral thigh flap Fabricated chimeric free flap