Osteocutaneous lateral arm flap in hand reconstruction

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Microsurgery

Background:

• Complex hand injuries frequently involve significant soft tissue damage and bone loss.
• Restoring the skeletal scaffold with bone grafts is crucial for effective soft tissue reconstruction.
• Non-vascularised bone grafts are often unsuitable for compromised vascular beds.

Purpose of the Study:

• To evaluate the efficacy of vascularised humeral bone grafting using osteocutaneous lateral arm flaps in complex hand reconstructions.
• To assess the viability and outcomes of this technique in patients with severe soft tissue damage and bone loss.

Main Methods:

• A retrospective review of 14 cases utilizing vascularised humeral bone grafts harvested as osteocutaneous lateral arm flaps.
• Preservation of constant osseous branches from the posterior radial collateral artery pedicle supplying the graft.
• Grafts provided composite osteocutaneous tissue for reconstruction.

Main Results:

• All 14 vascularised humeral bone grafts, combined with lateral arm flaps, survived successfully.
• Radiographic evidence at 3 to 6 months demonstrated consolidated bony union.
• Minimal to no significant bony resorption was observed post-operatively.

Conclusions:

• Vascularised humeral bone grafting with the lateral arm flap is a reliable method for reconstructing complex hand defects.
• This technique provides well-vascularised bone, facilitating successful osseous union and minimizing graft resorption.
• It represents a valuable option for challenging hand reconstructions where bone restoration is paramount.