J Korean Orthop Assoc.  2004 Jun;39(3):278-284.

Arterialized Venous Free Flap with Palmaris Longus Tendon for the One-Stage Reconstruction of Defects of Skin and Extensor Tendon

• Kim JS
• Woo SH
• Yoon JO
• Kim JS
• Chung MS
• Baek GH
• Kim YL

Abstract

PURPOSE
The purpose of this study was to introduce our new modified surgical method using a tendocutaneous flap, which is an arterialized venous free flap with palmaris longus tendon, to reconstruct composite defects of the dorsal skin and extensor tendons of the hand and to evaluate the clinical results. MATERIALS AND METHODS: Between March 1994 and December 2001, composite defects of the hands in 39 patients were reconstructed using various modifications of arterialized venous free flap. Among these patients, eight cases of tendocutaneous type were included in this study. The mean age of the patients was 33.2 years (ranging from 19 to 49), and the flap sizes ranged from 1.5x2 cm to 4x7 cm. In 2 of the 8 cases, neurorrhaphy using forearm cutaneous nerve was performed simultaneously for of digital nerve reconstruction. RESULTS: All flaps survived successfully and covered exposed bone and tendon. Marginal necrosis occurred partially in one case by less than 10% and this was completely recovered without any further surgical treatment. A functional range of motion (ROM) at the involved joint was achieved in an average ROM of 70 degrees at the PIP joint and 25 degrees at the DIP joint. CONCLUSION: Tendocutaneous arterialized venous free flap with palmaris longus tendon, is was found to be especially useful surgical foro reconstruct in a composite defects of the dorsal skin and extensor tendon of the hand.

Keyword

Hand composite defect; Tendocutaneous flap; Arterialized venous free flap

MeSH Terms

Forearm
Free Tissue Flaps*
Hand
Humans
Joints
Necrosis
Range of Motion, Articular
Skin*
Tendons*