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Arch Hand Microsurg > Volume 19(3); 2014 > Article
Journal of the Korean Society for Surgery of the Hand 2014;19(3):136-144.
Published online September 30, 2014.
DOI: https://doi.org/10.12790/jkssh.2014.19.3.136   
Functional Reconstruction of the Digit using Palmaris Longus Tendocutaneous Arterialized Venous Free Flap
Young Kun Lee, Joo Yong Kim, Seung Yeob Sagong, Young Woo Kim, Sang Hyun Woo
1Dason Orthopedic Clinic, Jeonju, Korea.
2Department of Orthopedic Surgery, Inje University Busan Baek Hospital, Busan, Korea.
3Cheon & Woo's Institute for Hand and Reconstructive Microsurgery, W Hospital, Daegu, Korea. handwoo@hotmail.com
Received: 28 August 2014   • Revised: 13 September 2014   • Accepted: 15 September 2014
Abstract
Purpose
The purpose of this study was to present the results after functional reconstruction of the digits using palmaris longus tendocutaneous arterialized venous free flap in digits with compound defects.

Methods
This study is based on 29 cases of palmaris longus tendocutaneous arterialized venous free flaps harvested from the ipsilateral wrist for the reconstruction of compound defect of the digits. Over the past 10 years, we performed in 17 cases of complex defects of extensor tendon on dorsum of the digits, 7 cases of collateral ligament of the proximal or distal interphalangeal joint and 5 cases of flexor tendon defect with soft tissue defect on the palmar aspect of the digits. We assessed survival rate of the flaps and functional recovery of the digits.

Results
All free flaps completely survived except one with completele necrosis and another one with 50% necrosis. In cases of extensor tendon defect, the mean total active range of motion of the digits was 180degrees, in cases of flexor tendon reconstruction, it was 165degrees. In reconstruction of collateral ligament of interphalangeal joint of the thumb and digits, flexion and extension was within normal range and we got very good results without instability in all 7 cases.

Conclusion
Palmaris longus tendocutaneous arterialized venous free flaps are very useful for reconstruction of composite defect of the digits with extensor or flexor tendons as well as collateral ligaments.
 


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