Effectiveness of free anterolateral thigh flap in repairing hand twist trauma combined with forearm main vascular injury

OBJECTIVE: To evaluate the effectiveness of free anterolateral thigh flap in repairing hand twist trauma combined with forearm main vascular injury.

METHODS: Between February 2016 and March 2020, 14 patients with hand twist trauma combined with forearm main vascular injury were admitted. There were 10 males and 4 females. The mean age was 36.3 years (range, 22-53 years). There were 5 cases with left hand and 9 cases with right hand. The degloving injury of hand was rated as type ⅢA in 2 cases, type ⅢB in 9 cases, and type Ⅳ in 3 cases. The size of soft tissue defects range from 8.0 cm×4.5 cm to 13.5 cm×8.0 cm. Of all patients, 11 cases were ulnar artery injury and 3 cases were radial artery injury. Time from injury to operation was 2-16 hours (mean, 7.1 hours). The free anterolateral thigh flaps with the size of 10.0 cm×5.5 cm to 15.0 cm×9.5 cm were used to repair the soft tissue defects with the "T" shape anastomosis of blood vessel in 8 cases or direct anastomosis of blood vessel in 6 cases. The donor sites were directly sutured in 9 cases and repaired with free skin graft in 5 cases.

RESULTS: All patients were followed up 6-12 months (mean, 10.5 months). The vascular crisis occurred in 1 case and the flap survived with symptomatic treatment after operation. Other flaps survived and the wounds healed by first intention. All donor sites healed by first intention and the skin grafts survived. Three cases underwent the fat-free trimming at 4-5 months after operation. According to the evaluation standard of the upper limb part of the Chinese Medical Association, the hand function was evaluated as excellent in 4 cases, good in 7 cases, and fair in 3 cases, with an excellent and good rate of 78.6% at last follow-up.

CONCLUSION: Because the diameter of the descending branch of the lateral femoral circumflex artery is similar to that of the ulnar artery and radial artery, the use of free anterolateral thigh flap can not only repair the wound and obtain a good hand shape, but also repair blood vessels and promote recovery of hand function.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:35

Enthalten in:

Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery - 35(2021), 8 vom: 15. Aug., Seite 1033-1037

Sprache:

Chinesisch

Beteiligte Personen:

Cai, Feiyu [VerfasserIn]
Jiasharete Jielile [VerfasserIn]
Liu, Kai [VerfasserIn]
Liu, Yanshi [VerfasserIn]
Fan, Chenchen [VerfasserIn]
Aihemaitijiang Yusufu [VerfasserIn]

Links:

Volltext

Themen:

Anterolateral thigh flap
Free flap
Hand injury
Journal Article
Vascular injury
Wound repair

Anmerkungen:

Date Completed 16.08.2021

Date Revised 07.12.2022

published: Print

Citation Status MEDLINE

doi:

10.7507/1002-1892.202103049

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM329312146