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Alternative hand flaps for amputations and digital defects

R C Russell, A L Van Beek, P Wavak

    The Journal of Hand Surgery
    |July 1, 1981
    PubMed
    Summary
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    This study explores four alternative hand flaps for composite tissue loss due to injury. These flaps offer solutions for complex hand defects, minimizing complications and improving coverage.

    Area of Science:

    • Reconstructive surgery
    • Hand surgery
    • Tissue engineering

    Background:

    • Composite tissue loss in the hand, resulting from traumatic or thermal injury, often exposes vital structures like tendons, bone, or joints.
    • Effective coverage of these exposed areas is crucial for function and preventing further complications.
    • Traditional methods may not always be suitable for complex defects, necessitating alternative reconstructive strategies.

    Purpose of the Study:

    • To discuss four alternative flap techniques for hand reconstruction.
    • To highlight their application in treating difficult hand injuries and minimizing complications.
    • To provide a resource for surgeons managing composite tissue loss in the hand.

    Main Methods:

    • The study reviews four distinct flap types: thumb flap, proximally based side-finger flap, deepithelized cross-finger flap, and proximally based arterialized side-finger flap.

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  • Each flap's specific application, donor site management, and unique characteristics are detailed.
  • Techniques for coverage of fingertip injuries, thumb tips, adjacent finger defects, and proximal interphalangeal joint exposure are described.

    • Main Results:

    • Thumb flaps provide primary closure for fingertip defects.
    • Side-finger flaps are effective for fingertip or thumb tip reconstruction.
    • Deepithelized cross-finger flaps, when reversed, can cover adjacent finger defects with skin grafting.
    • Arterialized side-finger flaps offer solutions for proximal interphalangeal joint coverage, especially in burn patients with limited donor sites.

    Conclusions:

    • Alternative flap techniques offer versatile solutions for complex hand tissue loss.
    • These methods can effectively cover exposed structures, minimize donor site morbidity, and address challenging reconstructive scenarios.
    • The selection of an appropriate flap depends on the defect location, patient factors, and availability of donor sites.