Successful Triple Flap Procedure for Thumb Reconstruction in Severe Hand Crush Injury

Area of Science:

• Reconstructive surgery
• Microsurgery
• Hand surgery

Background:

• Thumb function is vital for hand aesthetics and utility.
• Crush injuries to the thumb present complex reconstructive challenges.
• Optimal treatment strategies for severe thumb crush injuries lack consensus.

Observation:

• A 47-year-old male sustained a severe left hand crush injury with thumb amputation and complex fractures.
• The patient underwent a two-stage surgical approach, including debridement and a triple flap reconstruction.
• The triple flap utilized scapular, parascapular, and osteo-cutaneous parascapular components, vascularized by the circumflex scapular and thoracodorsal arteries.

Findings:

• The triple flap procedure was successfully implemented, maintaining flap viability.
• Postoperatively, the patient demonstrated significant recovery of hand strength and function.
• The reconstructive approach addressed extensive soft tissue damage and bone fractures.

Implications:

• Severe hand crush injuries, including thumb amputation, necessitate tailored surgical planning.
• Triple flap reconstruction offers a viable option for restoring function in complex hand injuries.
• Personalized surgical strategies are crucial for achieving optimal outcomes in severe hand trauma.