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Restoration of basic hand function following devastating hand injuries using a microsurgically fabricated chimeric
Zhao Hui Pan1, Ping Ping Jiang1, Shan Xue1
1Institute of Orthopedic Trauma Surgery of the Chinese People's Liberation Army, 89th Hospital, Weifang, China.
Summary
Microsurgically fabricated chimeric flaps, combining anterolateral thigh and superficial circumflex iliac artery osteocutaneous flaps, offer a viable solution for reconstructing severe hand injuries involving multiple digit amputations.
Area of Science:
- Plastic Surgery
- Microsurgery
- Hand Reconstruction
Background:
- Reconstructing hands after severe trauma, especially with thumb and multiple digit amputations, presents significant challenges.
- Combined flap transfers are potential reconstructive options for such complex cases.
Observation:
- Six patients with devastating hand injuries underwent reconstruction using sequential chimeric flaps: sensate anterolateral thigh free flaps and superficial circumflex iliac artery osteocutaneous flaps.
- Flap sizes varied, with anterolateral thigh flaps ranging from 8x16 cm to 10x25 cm, and superficial circumflex iliac artery osteocutaneous flaps having cutaneous portions from 4x5 cm to 7x15 cm and bone portions from 1x3x0.8 cm to 1x4x1 cm.
Findings:
- All flaps survived without complications.
- Patients regained basic hand functions, including improved pulp-to-palm distance, pinch strength, and sensation, with a median follow-up of 1.8 years.
- Modified DASH scores indicated functional improvement post-reconstruction.
Implications:
- Microsurgically constructed chimeric iliac osteocutaneous flaps can restore essential hand function after severe trauma.
- This technique represents a valuable option for carefully selected patients requiring complex hand reconstruction.