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1. Case Report of Four Patients with Scar Contractures Due to
Severe Detrition/Burn in The Hand Who Underwent Reconstructive Surgery with A Free Anterior Lateral Thigh Flap
Kato H, Aoi N, Uchida G, Gonda K, Yoshimura K, Koshima I
Department of Plastic and Reconstructive Surgery, University of Tokyo,
Tokyo, Japan
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In patients with severe detrition and postburn scar in the hand, simple
skin grafting to repair the damage during primary surgery cannot prevent
recurrent scar contracture. The functional outcome depends primarily on
contracture in the proximal interphalangeal joint and the joint between
the thumb and index finger. We propose that reconstructive surgery with
a free anterior lateral thigh (ALT) flap results in a good outcome in
hand reconstruction. Here we report the procedure and its results in 4
patients (postburn scar: 1, severe detrition: 3). The ALT flap can be
planed down, and a relatively large single flap is sufficient to
completely cover the palm and dorsum of the hand. The adipose tissue
attached to the skin flap aids in movement of the underlying tendon.
This reconstruction has additional advantages, including both vascular
anastomosis with a flow-through free flap and vascular anastomosis that
can achieve blood flow through the free flap using a T-shaped vessel. In
conclusion, reconstruction with a free ALT flap is considered useful for
the prevention or release of contractures. |
