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Free Tissue Transfer for Upper Extremity Reconstruction.

Rami Dibbs1, Luke Grome1, William C Pederson1

  • 1Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Seminars in Plastic Surgery
|March 14, 2019
PubMed
Summary
This summary is machine-generated.

Free tissue transfer, including fasciocutaneous, muscle, and functional flaps, offers advanced reconstructive options for traumatic upper extremity injuries when other methods fail.

Keywords:
fasciocutaneous flapfree flapfunctional tissue transfermuscle flapupper extremity reconstruction

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Area of Science:

  • Orthopedic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Traumatic upper extremity injuries increased significantly post-Industrial Revolution, leading to amputation as standard care.
  • Pedicled flaps became common for reconstruction after World War II.
  • Microsurgery now provides advanced alternatives for complex upper extremity reconstruction.

Purpose of the Study:

  • To review the application of free tissue transfer in upper extremity reconstruction.
  • To categorize and highlight various flap types used in this context.

Main Methods:

  • Review of literature on free tissue transfer for upper extremity reconstruction.
  • Categorization of flaps into fasciocutaneous, muscle, and functional tissue transfers.
  • Discussion of specific flap examples and their applications.

Main Results:

  • Fasciocutaneous flaps (e.g., radial forearm, anterolateral thigh) are ideal for aesthetic reconstruction.
  • Muscle flaps (e.g., latissimus dorsi) provide bulk for large defects.
  • Functional transfers (e.g., innervated gracilis, vascularized bone, toe-to-thumb) restore motion and bony integrity.

Conclusions:

  • Free tissue transfer represents a sophisticated option for challenging upper extremity reconstructions.
  • Diverse flap types allow for tailored solutions based on defect characteristics.
  • Microsurgical techniques enable restoration of form and function in severe upper extremity trauma.