REVERSE RADIAL ARTERY FLAP FOR SOFT TISSUE DEFECTS OF HAND IN PEDIATRIC AGE GROUP

Authors

  • Saeed Ashraf Cheema
  • Nabeela Talaat

Abstract

Background: To highlight the usefulness of reverse radial artery flap in covering various soft tissuedefects of hand in paediatric age group. Methods: A total of 16 reverse radial artery flaps were utilized ina period of three years to cover various soft tissue defects of hand for paediatric age group patients. Theage ranged from 5–18 years. The two common causes of soft tissue defects in this series were mechanicaltrauma and fireworks trauma with five cases in each group. Three of the cases were burn victims and othertwo presented with earth quake injuries. One patient had wound because of road traffic accident. Softtissue defects of palm were covered with this flap in eight cases while in three cases it was wrappedaround the thumb. First web space defects were covered with this flap in two cases. Two cases requiredcoverage of amputation stump at transmetacarpal level and yet another required a big flap to cover the softtissue defects at palm, dorsum and thumb. Donor site was covered with split skin graft in all cases but one,which was closed primarily. Results: We had partial loss of flap in one case. Grafted donor sites healeduneventfully and were quite acceptable to the patients in due course of time. Conclusion: Reverse radialartery flap has a quite long arc of rotation which brings it great ease to cover the soft tissue defects ofvarious areas of hand like palm, dorsum, first web space and thumb.Keywords: Reverse radial artery flap, Hand injuries, Paediatric hand trauma

References

Cheema SA. Patterns of hand injuries and reconstruction

modalities. Esculapio. J Serv Inst Med Sci Lahore

;2(1):26–9.

Moss CJ. Machinery hazards. Ann Occup Hyg 1969;12(2):69–75.

Chari PS, Kharshiing W, Balakrishnan C. Wheat thresher

hand injuries. Indian J Med Res 1975;63:829–32.

Medalie DA. Perforator-Based Forearm and Hand

Adipofascial Flaps for the Coverage of Difficult Dorsal Hand

Wounds. Ann Plast Surg 2002;48(5):477–83.

Kelleher JC, Sullivan JC, Baibak GI. Large compound axial

vessel abdominal pedicle flap: indications for its use in

surgery of the hand. Ortho Clin North Am 1970;1:227.

White WL. Flap grafts to upper extremity. Surg Clin North

Am 1960;40:389–97.

McGregor IA, Jackson IT. The groin flap. Br J Plast Surg

;25:3–16.

Wray RC, Wise DM, Young VL, Weeks PM. The groin flap

in severe hand injuries. Ann Plast Surg 1982;9:459–62.

Ragnell A. The Secondary contracting tendency of free skin

grafts. Br J Plast Surg 1952;5:6–24.

Inoue G, Suzuki K. Arterialized venue flap for treating

multiple skin defects of the hand. Plast Reconstr Surg

;91:299–302.

Soutar DS, Tanner NS. The radial forearm flap in the

management of soft tissue injuries of the hand. Br J Plast

Surg 1984;37:18–26.

Govila A, Sharma D. The radial forearm flap for

reconstruction of the upper extremity. Plast Reconstr Surg

;86:920–7.

Angrigiani C, Grilli D, Dominikow D, Zancolli EA. Posterior

interosseous reverse forearm flap: Experience with 80

consecutive cases. Plast Reconstr Surg 1993;92:285–93.

Kaufman MR, Jones NF. The Reverse radial forearm flap for

soft tissue reconstruction of the wrist and hand. Tech Hand

Up Extrem Surg. 2005;9(1):47–51.

Rogachefsky RA, Mendietta CG, Galpin P, Ouellette EA..

Reverse radial forearm fascial flap for soft tissue coverage of

hand and forearm wounds. J Hand Surg 2000;25(4):385–9.

Soutar DS, Tanner NSB. The radial forearm flap in the

management of soft tissue injuries of the hand. Br J Plast

Surg 1984;37:18–26.

Al-Qattan MM, Ziesmann M. Immediate de-syndactylization

of the reverse radial forearm flap. The Journal of Hand

Surgery 2000;25(1):61–4.

Jones BM, O'Brien CJ. Acute ischemia of the hand resulting

from elevation of a radial forearm flap. Br J Plast Surg

;38:396–7.

Small JO, Millar R. The radial artery forearm flap: An

anomaly of the radial artery. Br J Plast Surg 1985;38:501–3.

Published

2009-03-01

Issue

Vol. 21 No. 1 (2009): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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