The Bilobed Racquet Flap or Extended Seagull Flap for Thumb Reconstruction: A Case Report

2018 ◽  
Vol 23 (01) ◽  
pp. 128-131
Author(s):  
José Couceiro ◽  
Mariangeles De la Red-Gallego ◽  
Luis Yeste ◽  
Higinio Ayala ◽  
Manuel Sanchez-Crespo ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Thumb Reconstruction ◽  
Degloving Injury ◽  
Dorsal Metacarpal Artery ◽  
The Subject ◽  
Tissue Defects

The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition. We report the salvage of a thumb degloving injury with use of a bilobed racquet flap.

scholarly journals Soft tissue reconstruction of low voltage electric burn injuries of the thumb and first web space by the first dorsal metacarpal artery island flap: a three-year study from Eastern India

2020 ◽  
Vol 7 (4) ◽  
pp. 1082
Author(s):  
Madhumita Gupta ◽  
Prabir Kumar Jash
Keyword(s):  
Soft Tissue ◽  
Low Voltage ◽  
Burn Injuries ◽  
Soft Tissue Defects ◽  
Dorsal Metacarpal Artery ◽  
Web Space ◽  
Electric Burns ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

Background: Complex soft tissue defects of thumb and first web space are a reconstructive challenge. Low voltage electric burns of the hand commonly result in localised and deep soft tissue destruction. The first dorsal metacarpal artery flap (FDMA) is an attractive local flap option to reconstruct these. This study illustrates our experience with the same.Methods: Between March 2014 and February 2017, 16 patients with complex soft tissue defects of thumb and first web space resulting from low voltage electric burns underwent reconstruction with the FDMA flap and subsequent structured hand therapy. In the follow up visits objective assessment of hand function included tests of mobility using Kapandji Score, sensory evaluation with static 2 point discrimination and cortical reorientation. The Subjective Satisfaction Score was used to ascertain the patient’s overall perception of aesthetic and functional outcome.Results: Majority (43.75%) of the patients had defects involving the thumb IP joint. No case of complete flap failure was noted. In a mean follow-up of 11.5 months the reconstructed thumb showed return of good protective sensation as well as mobility. Though cortical reorientation was complete in only 18.75 %, it did not substantially impede hand functioning. All patients were satisfied with the functional and aesthetic result.Conclusions: In cases of low voltage electric burn injuries the FDMA flap is a reliable reconstructive option for small to moderate sized complex defects of thumb and first web space. It has minimal donor site morbidity and can be accomplished in a relatively simple single stage procedure.

scholarly journals The Holevich modification of the first dorsal metacarpal artery flap in coverage of thumb skin losses

2019 ◽  
Vol 5 (6) ◽  
pp. 1144
Author(s):  
Prakash Panagatla ◽  
Sindhuri Kondapavuluri ◽  
Parvathi Ravula
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Soft Tissue Defects ◽  
Average Hospital ◽  
Sensory Recovery ◽  
Dorsal Metacarpal Artery ◽  
The Mean ◽  
And Function ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

<p class="abstract"><strong>Background:</strong> Reconstruction of complex soft tissue defects of the thumb is a challenging problem. It is very important to reconstruct these defects using sensate flaps as the thumb pulp needs to be sensate for implementing the various functions of the thumb. The aim of this study is to report our experience on the safety and functional outcome of the innervated first dorsal metacarpal artery flap (FDMA) for soft tissue defects of thumb.</p><p class="abstract"><strong>Methods:</strong> During 18 month period, nine patients with a mean age of 29 years, male:female ratio of 8:1 underwent coverage of soft tissue defects of the thumb, of various volar and dorsal defects, using an innervated first dorsal metacarpal artery flap. Indications were postburn deformities and acute trauma. None of the patients had any neurorraphy. Outcome of the Holevich modification of FDMA flap was assessed with regards to survival and function, reachability for different locations of the thumb, recovery of sensation in terms of two-point discrimination (2PD), donor morbidity with regards to deformity and range of motion were analysed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean size of the defect was 6.7 cm<sup>2</sup>. Average hospital stay was 5 days. Average time of sensory recovery was 6 months. The mean 2PD was 4 mm (range 2-6 mm). All patients had a normal active range of motion in the donor finger. One of nine patients had distal flap marginal necrosis of 3-4 mm; it healed with debridement and regular dressings over 12 days.</p><p class="abstract"><strong>Conclusions:</strong> The Holevich modification ensures the safety of the innervated FDMA flap in thumb defect coverage with good recovery of sensation.</p>

scholarly journals Functional and aesthetic outcomes of first dorsal metacarpal artery flap for thumb reconstruction: a prospective study

2020 ◽  
Vol 7 (7) ◽  
pp. 2268
Author(s):  
Sujana Ravada ◽  
Surya Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Sensory Function ◽  
Soft Tissue Defects ◽  
Aesthetic Outcome ◽  
Dorsal Metacarpal Artery ◽  
The Mean ◽  
The Aesthetic ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

Background: Reconstruction of soft tissue defects of the thumb, with exposure of tendon, joint or bone, has been a challenging problem. Surgical options include local, regional or free flaps. Here, we have evaluated the functional and aesthetic outcomes of first dorsal metacarpal artery (FDMA) island flap in reconstruction of various soft tissue defects of the thumb.Methods: Between January 2018 and January 2019, twenty patients with post-traumatic and post-infective thumb defects underwent FDMA flaps. Sensory function was evaluated with static 2 point discrimination and mobility of the thumb was tested by the Kapandji score. The aesthetic outcome was also assessed.Results: The mean defect size was 39.9×19.95 mm. Eighteen flaps survived completely and one had distal flap necrosis and one had superficial epidermal peeling which was treated conservatively. The mean static two-point discrimination was 9.3 mm. Cortical reorientation was complete in 45%. The average Kapandji score was 7.9. The aesthetic outcome was excellent in ten, good in eight and poor in two subjects. After a mean follow up period of 11.85 months, most patients regained all functions of the thumb and index finger and were pleased with the cosmetic appearance of the flap and donor site.Conclusions: FDMA flap offers a good quality skin cover for small to moderate sized thumb defects. It is a reliable and versatile flap which is sensate and pliable. It gives excellent functional and aesthetic outcomes with minimal or no donor site morbidity.

scholarly journals Brachioradialis Flap With Vascularized Lateral Ulnar Collateral Ligament Reconstruction: A Case Report

Hand ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. NP37-NP41
Author(s):  
Nicholas A. Trasolini ◽  
Jerry Chidester ◽  
Alidad Ghiassi ◽  
Milan Stevanovic
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Ulnar Collateral Ligament ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Collateral Ligament ◽  
Lateral Ulnar Collateral Ligament ◽  
Lateral Elbow ◽  
Rotational Flap ◽  
Tissue Defects

Background: Soft tissue defects about the elbow with concurrent ligamentous instability can be challenging to treat. Methods: We present a case report of a lateral elbow wound that resulted in lateral ulnar collateral ligament deficiency and posterolateral elbow instability. Results: We describe our technique of a modified brachioradialis rotational flap, in which the muscle is rotated to cover the soft tissue defect, while the vascularized brachioradialis tendon is used to simultaneously reconstruct the lateral ulnar collateral ligament. This procedure successfully restored posterolateral elbow stability at the time of wound coverage. Conclusion: Elbow soft tissue defects with associated ligamentous injuries can be treated using a modification of the brachioradialis rotational flap.

Application of the Dorsal Metacarpal Artery Perforator Flap for Resurfacing Soft-Tissue Defects Proximal to the Fingertip

2011 ◽  
Vol 128 (3) ◽  
pp. 166e-178e ◽  
Author(s):  
Sandeep J. Sebastin ◽  
Romina T. Mendoza ◽  
Alphonsus K. S. Chong ◽  
Yeong P. Peng ◽  
Shimpei Ono ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Perforator Flap ◽  
Soft Tissue Defects ◽  
Dorsal Metacarpal Artery ◽  
Artery Perforator ◽  
Tissue Defects

scholarly journals Fasciocutaneous flaps in the management of soft-tissue defects of the lower leg caused by explosive weapons

2004 ◽  
Vol 61 (1) ◽  
pp. 77-81
Author(s):  
Aleksandar Petkovic ◽  
Srbobran Trenkic ◽  
Goran Stevanovic ◽  
Zoran Rancic ◽  
Zoran Golubovic ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Reliable Method ◽  
Distal Segment ◽  
Lower Leg ◽  
Soft Tissue Defects ◽  
Fasciocutaneous Flaps ◽  
Leg Injuries ◽  
War Wounds ◽  
Tissue Defects

The use of fasciocutaneous flaps for the reconstruction of lower leg soft-tissue defects inflicted during the bombing of our country is presented in this case report. The experience with 9 patients with soft-tissue defects of the lower leg is presented with the aim of examining the possibilities of war-wound reconstruction. The results of the earlier use of fasciocutaneous flaps in the lower leg reconstruction as well as the those obtained during the reconstruction of the lower leg soft-tissue defects in war wounds was proven to be safe and reliable method of the reconstructions of severe lower leg injuries, particularly of its distal segment and the malleolus region.

scholarly journals Versatility of Reverse Sural Artery Flap for Coverage of Heel and Proximal Foot Defects in Children

2021 ◽  
Vol 15 (7) ◽  
pp. 1755-1759
Author(s):  
Muhammad Anwar ◽  
Faisal Waheed ◽  
Khadija Hussain
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Case Series ◽  
Soft Tissue Defects ◽  
Degloving Injury ◽  
Case Series Study ◽  
Study Results ◽  
Sural Artery ◽  
Tissue Defects ◽  
Ankle And Foot

Objective: The objective of the study was to determine the versatility of reverse sural artery flap in terms of its reliability and efficacy for reconstruction of soft-tissue defects of heel and proximal foot in children. Material and Methods: A total of 30 patients aged 5-13 years with ankle and foot defects admitted to the Plastic Surgery and Burn department at the Sheikh Zayed Hospital, Rahim Yar Khan from January 2018 to July 2020 were studied by designing a retrospective cross-sectional case series study. Results: Out of 30 flaps, 26 (86.7%) healed fully, whereas 4 (13.3%) complicated by partial necrosis requiring a secondary procedure. Nineteen (63.3%) patients had wheel spoke injuries, eight (26.6%) sustained degloving injury after a road traffic accident, and three (0.1%) patients were having a history of electric burn. In 22 patients an interpolated flap was used and in 8 cases an islanded flap. Donor sites were skin grafted in all patients. Two patients developed hypertrophic scarring at donor area. All patients showed good functional results, however flap remained insensate throughout the follow-up period that was minimum for 6 months. Conclusion: The reverse sural artery flap is versatile, reliable and a method of choice in reconstructing soft-tissue defects of the hind foot in children. This flap is easy to dissect, has robust blood supply and does not sacrifice any major blood vessel of the leg. Key Words: Reverse Sural Artery Flap, children, Ankle and Foot, Soft-tissue Defects, Wheel Spook Injury

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