Reconstruction of Multiple Digital Defects by Temporary Syndactylization Using a Lateral Arm Free Flap

Area of Science:

• Plastic Surgery
• Hand Surgery
• Microsurgery

Background:

• Reconstructing multiple finger soft tissue defects poses significant challenges for surgeons.
• Existing methods may have limitations in addressing extensive digital injuries.

Purpose of the Study:

• To evaluate the efficacy of using a lateral arm free flap combined with temporary syndactylization for covering multiple finger soft tissue defects.
• To analyze surgical and functional outcomes, complications, and flap viability in patients undergoing this reconstructive procedure.

Main Methods:

• A retrospective review of 13 patients with 33 finger defects treated between January 2010 and December 2020.
• The technique involved microvascular lateral arm free flap transfer and temporary syndactylization, followed by flap division 3-9 weeks post-surgery.
• Surgical outcomes, functional results, flap survival, and complications were analyzed.

Main Results:

• Middle fingers were most commonly affected, followed by ring and index fingers.
• The mean patient age was 43.58 years, with defects primarily resulting from trauma, burns, or scar contracture.
• All flaps survived, with one instance of partial flap necrosis requiring secondary reconstruction. Mean follow-up was 15.8 months.

Conclusions:

• Temporary syndactylization with a free lateral arm flap provides a successful alternative for reconstructing multiple finger soft tissue defects.
• This technique offers a promising option for complex digital reconstructions, achieving good flap survival and functional outcomes.