Use of the Tenocutaneous Free Flap In Hand Reconstruction

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Journal of the Korean Society for Surgery of the Hand 2001;10(2):93-98.
Published online November 30, 2001.

Duke Whan Chung, M.D., Chung Soo Han, M.D. and Ki Bong Kim, M.D., Jin Woong Yi, M.D.

유리 건 피판을 이용한 수부 재건술

정덕환·한정수·김기봉·이진웅

Abstract

Purpose : This describes our experience with a tenocutaneous free flap from the dorsum of the foot or radial forearm to reconstruct the dorsal skin and extensor tendons of the hand.
Material and Methods : Between february 1987 and July 1998, we treated 9 patients with composite tissue loss on the dorsal hand caused by crushing injury. Nine men had an average age of 26.4 years(range, 19~47). We treated 5 patients with the free dorsalis pedis flap including the extensor tendons and the superficial peroneal nerve and 4 patients with reverse forearm flap including the brachioradialis tendon and/or superficial radial nerve. Flap size was average 4.4( 3.2cm. Evaluation of the results was based on the survived flap rate, the recovery rates for range of motion of the metacarpophalageal joints in the operated fingers, two-point discrimination.
Results : All flaps were well vascularized and survived completely. Recovery rates for range of motion of the metacarpophalageal joints in operated fingers range from 78%~99%(average, 90%). Two-point discrimination of the transferred flaps in 5 patients average 20±3.5 mm.
Conclusion : The advantages of this procedure are mass action reconstruction with tendon, onestage operation, faster healing with less adhesion formation, and early mobilization.

Key Words: Hand, Soft tissue defect, Tenocutaneous free flap

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