[Radial artery perforator flaps in posttraumatic thumb reconstructions]

Between 2002 and 2008 author treated 6 patients aged 15-40 (mean 24 years), after severe hand injuries reconstructing soft tissues of the first ray with various flaps based on perforators of distal part of radial artery. All patients requested secondary thumb reconstruction due to its amputation and disfigurement of the hand (particularly tissues of the first ray). Following three different forearm flaps based on radial artery perforators were used: adipo-cutaneous, fascio-cutaneous and island fascio-cutaneous. Primary closure of the donor site was possible in 4 cases. In remaining two patients split thickness skin grafts were used. All flaps survived. Minor partial necrosis did not impaired reconstruction of the first ray soft tissues. In two patients thumb reconstruction by the second toe transfer and rebuilt first ray soft tissues were performed in one procedure. Author suggests broader application of distal radial artery perforator flaps in soft tissues reconstruction of the first ray of the hand.