Bone Grafts and Flaps in the Management of Complex Upper-Extremity Defects: Indications and Outcomes

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Reconstructing bony defects presents significant challenges in orthopedic and reconstructive surgery.
• Nonvascularized bone grafts are suitable for many cases, but limitations exist for complex defects.

Purpose of the Study:

• To review and present the most effective vascularized bone flaps for reconstructing small and long defects in the hand and upper limb.
• To provide guidance on flap selection for challenging bony defect scenarios.

Main Methods:

• Literature review of established and innovative vascularized bone grafting techniques.
• Analysis of flap suitability based on defect size, location, and associated tissue loss.

Main Results:

• Vascularized bone grafts are superior for defects requiring cartilage inclusion, combined soft tissue coverage, or in compromised wound beds.
• Specific flaps are identified as highly useful for both small and extensive defects in the hand and upper limb.

Conclusions:

• Vascularized bone grafting is a critical technique for complex bony defect reconstruction.
• The selection of appropriate flaps is crucial for successful outcomes in hand and upper limb surgery.