Repair of compound defect in the hand by compound or combined flap transfer / 中华显微外科杂志

ABSTRACT

Objective To introduce the outcome of compound defect in the hand treated by compound flap transfer or combined flaps transfer. Method From Dec.1983 to June 2001,thirty-five cases with five kinds of compound defect in the hand were treated surgically.Among them,four cases with defect of skin and extensor tendon in the dorsum of hand were repaired by dorsalis pedis flap with tendons;Three cases with longitudinal subtotal loss of distal thumb and one case with longitudinal subtotal loss of distal middle finger were reconstructed with fibular segmental osteo-onychocutaneous flap from great toe or tibial segmental osteo-onychocutaneous flap from second toe;Eight cases with total or subtotal defect at middle part of thumb or fingers were reconstructed with segmental second toe; seventeen cases with defect of thumb and hand skin were reconstructed with combined transplantation of second toe and free skin flap;Two cases with middle finger defect at the base of proximal phalanx were reconstructed with bridging transplantation of bilateral second toe. Result Thirty-three cases were successful.Follow-up period ranged from 0.5 to 5 years postoperatively.The excellent and good rate was 82.9% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery. Conclusion The compound flap transfer or combined flaps transfer was an ideal method in repair of compound defect in the hand.