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KMID : 1143020200250040287
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Archives of Hand and Microsurgery
2020 Volume.25 No. 4 p.287 ~ p.291
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Kirschner Wire Fixation for Immobilization of the Thenar Flap in an Uncooperative Pediatric Patient: A Case Report
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Yoo Hyo-Kyung
Kim Yung-Hoon
Kwon Sung-Tack
Kim Byung-Jun
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Abstract
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Thenar flap is a commonly used operational method in fingertip reconstruction. It should be maintained for 2 to 3 weeks before flap division until the neovascularization is established from the fingertip to the flap. However, immobilization between two stages of operation is challenging especially in uncooperative pediatric patients. A 47-month-old female with a ring fingertip amputation underwent soft tissue reconstruction with thenar flap. Two days postoperatively, the flap’s proximal margin was found disrupted. Flap revision was performed, followed by applying a transphalangeal Kirschner wire (K-wire) between the thumb proximal phalanx and ring finger middle phalanx. The flap was successfully divided two weeks after the original operation. The result was aesthetically pleasing, and no complication was observed, including dehiscence, necrosis, limitation of range of motion, and visible scar of the pinning sites. In conclusion, K-wire fixation is a safe and effective method to immobilize thenar flap in uncooperative pediatric patients.
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KEYWORD
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Surgical Flaps, Bone wires, Fingers, Immobilization, Pediatrics
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