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Updated: Mar 9, 2026
Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
Free lateral tarsal artery perforator flap with functioning extensor digitorum brevis muscle for thenar
Tianliang Wang1, Subhash Regmi2, Hongjun Liu1,3
1Department of Hand and Foot Surgery, Rui Hua Hospital, Affiliated Hospital of Suzhou University, 5 Tayun Road, Yuexi Town, Wuzhong District, Suzhou, 215104, Jiangsu, People's Republic of China.
Abstract:
In this case report, we describe reconstructive surgery in one patient using a free lateral tarsal artery perforator flap with a functioning extensor digitorum brevis muscle. A 47-year-old woman sustained a crush-avulsion injury to her dominant right hand while working in a factory. A large thenar skin and muscle defect (5.5 cm × 4.0 cm) occurred as a consequence of surgical debridement. The skin and muscle defect was repaired using a free lateral tarsal artery perforator flap with a functioning extensor digitorum brevis muscle in a single operation. The donor site defect was repaired using a full-thickness skin graft. The patient recovered without postoperative complications. The patient showed satisfactory functional gain without significant donor site morbidity at the 4-year follow-up visit. Thus, we have demonstrated that a functional reconstruction of a thenar skin defect complicated by muscle loss is possible by transferring a free lateral tarsal artery perforator flap with the underlying extensor digitorum brevis muscle.
