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"A free thenar flap--a case report".

Rajesh Garg1, Boris K K Fung, Shew Ping Chow

  • 1Department of Orthopaedic Surgery, Hand and Foot Division, Queen Mary Hospital, University of Hong Kong, Hong Kong. drgarg@rediffmail.com

Journal of Orthopaedic Surgery and Research
|March 14, 2007
PubMed
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This case report details a successful free thenar flap surgery for a severe middle finger degloving injury. This flap offers excellent outcomes with minimal donor site issues and no need for post-operative immobilization.

Area of Science:

  • Hand surgery
  • Microsurgery
  • Reconstructive surgery

Background:

  • Degloving injuries to the hand, particularly the fingers, present significant reconstructive challenges.
  • Restoring both form and function is crucial for patient outcomes.
  • Free thenar flaps offer a potential solution for complex soft tissue defects.

Purpose of the Study:

  • To report a case of free thenar flap reconstruction for a volar degloving injury of the right middle finger.
  • To highlight the advantages of using a free thenar flap in this specific clinical scenario.

Main Methods:

  • A free thenar flap, a fasciocutaneous flap with neurovascular supply from the superficial radial artery and its nerve, was harvested.
  • The flap was transferred to reconstruct the degloved segments of the distal and middle phalanges of the right middle finger.

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  • Post-operative management involved monitoring flap viability and function.

    • Main Results:

    • The free thenar flap provided adequate soft tissue coverage for the injured finger segments.
    • The flap demonstrated good viability and sensory recovery.
    • The donor site exhibited low morbidity and was closed primarily.
    • No post-operative immobilization was required, allowing early mobilization.

    Conclusions:

    • Free thenar flaps are a viable and effective option for reconstructing volar degloving injuries of the fingers.
    • This technique offers advantages such as good cosmesis, texture match, low donor site morbidity, and early functional recovery.
    • The absence of required immobilization simplifies post-operative care and improves patient compliance.