Author reviewed 100 cases of free flaps performed between Sept. 1985 and Feb, 1992 in 95 patients who had soft tissue defects of the hand and wrist. The ages ranged from 10 to 62 years. There were 86 male and 9 female. The most frequent cause was
crushing injury as 42(44.2%) patients. Thirteen type of free vascularized cutaneous, myocutaneous, muscular, fasciocutaneous, fascial, sensate tissue transfers were used. Groin free flap was the most frequently performed tissue transfer. The
overall
success rate was 96%.
In my experience, for defects in thumb, wrap around free flap was the choice of free flap, but in other fingers, parietotemporal fascial flap with skin graft, and in dorsum of the hand, dorsalis pedis or parietotemporal fascial free flap were
good.
For
reconstruction of first web space defects, lateral arm free flap, and for stump coverage, groin or scapular free flap were suitable. In-step free flap was recommened for reconstruction of palmar defects. Free tissue transfers provided a very
reliable
method form deling with difficult reconstructive problems in soft tissue defects of the hand and wrist.
|