Atypical fibroxanthoma of hand

Atypical fibroxanthoma (AFX) is a rare cutaneous ulcerative lesion with a good prognosis. Diagnosis is difficult and is usually made by exclusion from pleomorphic dermal sarcoma and squamous cell carcinoma. Definitive treatment varies from Mohs micrographic surgery to wide local excision. We present a case of 76-year-old woman with AFX over the dorsum of her left hand. The tumour was excised and the resulting defect was reconstructed with a local second dorsal metacarpal artery perforator flap.

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Dorsal Metacarpal Artery Flap and Dorsal Metacarpal Artery Perforator Flap

Operative Techniques: Hand and Wrist Surgery ◽

10.1016/b978-0-323-40191-3.00074-3 ◽

2018 ◽

pp. 678-685

Author(s):

Guang Yang ◽

Kevin C. Chung

Keyword(s):

Perforator Flap ◽

Dorsal Metacarpal Artery ◽

Artery Perforator

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Dorsal Metacarpal Artery Perforator Flap for Skin Ulcer Due to a Postoperative Complication of Suture Anchor Treatment for Tendinous Mallet Finger

Plastic Surgery Case Studies ◽

10.1177/2513826x20957128 ◽

2020 ◽

Vol 6 ◽

pp. 2513826X2095712

Author(s):

Koichi Yano ◽

Yasunori Kaneshiro ◽

Ryo Sasaki ◽

Seungho Hyun ◽

Hideki Sakanaka

Keyword(s):

Suture Anchor ◽

Perforator Flap ◽

Skin Ulcer ◽

Ulcer Formation ◽

Skin Defect ◽

Mallet Finger ◽

Initial Surgery ◽

Finger Injury ◽

Dorsal Metacarpal Artery ◽

Artery Perforator

The suture anchor method of surgery has some complications. To best of our knowledge, no report on skin ulcer formation apart from the surgical site after tendinous mallet finger injury using suture anchor is available. We present the case of a 73-year-old woman who sustained tendinous mallet finger in an accident. She was treated surgically with a suture anchor. At 12 months after surgery, the string from the surgical site was removed; 28 months after surgery, a skin ulcer was formed 2-cm proximal from the operative scar, and discharge leaked from the dorsal middle phalanx. Because the wound could not heal by conservative treatment, it was treated surgically. At initial surgery, debridement of the skin ulcer, including the suture knot, was performed. At second surgery, the skin defect was reconstructed using a third dorsal metacarpal artery perforator flap. At 1 year postoperatively, she had no symptoms without recurrence.

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Reconstruction of the First Web Space Using the Wide-Second Dorsal Metacarpal Artery Perforator Flap

Archives of Hand and Microsurgery ◽

10.12790/ahm.21.0081 ◽

2021 ◽

Author(s):

Su Hyun Choi ◽

Ho Jun Cheon ◽

Sang Ho Oh ◽

Sang Hyun Woo

Keyword(s):

Donor Site ◽

Perforator Flap ◽

Extensor Retinaculum ◽

Dorsal Metacarpal Artery ◽

The Mean ◽

Web Space ◽

Normal Thickness ◽

Excellent Color ◽

Artery Perforator

Purpose: This study evaluated the functional and aesthetic outcomes of a wide-second dorsal metacarpal artery perforator flap for reconstruction of the first web space of the hand. This flap sets the proximal edge of the extensor retinaculum as the distal limit.Methods: We measured the preoperative and postoperative angles of the first web space and assessed the quality of the donor site scar in eight patients.Results: The average flap size was 5.5 × 2.8 cm (range, 5.0 × 1.5 cm to 5.0 × 6.0 cm), and all flaps survived completely. The mean postoperative angle was 53°. The mean Vancouver Scar Scale score of the donor site was 4 points, and the patients had near-normal thickness and vascularity values. There was no distortion of the scar, and patients were satisfied with the scar appearance of the donor site.Conclusion: The wide-second dorsal metacarpal artery perforator flap is a useful technique to reconstruct large defects of the first web space. It is easy to raise, thin, and pliable, and has excellent color and tissue matching.

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