POSTERIOR INTEROSSEOUS FLAP IN PEDIATRIC HAND RECONSTRUCTIONS

Cover Page


Cite item

Abstract

Purpose: to assess early and long-term results of the pediatric hand reconstructions with posterior interosseous flap, including those in children younger than 3 years old. Materials and methods: results of the hand reconstructions with posterior interosseous artery reverse flap were studied in 10 children (4 males and 6 females) aged from 1 year and 1 month to 13 years old. In 4 cases flap coverage were performed due to acquired posttraumatic hand deformity, in 6 cases reconstruction was assumed for congenital hand deformities. Combined procedures consisted of posterior interosseous artery flap coverage and other types of microsurgical reconstructions were suggested in 4 patients. Preoperative color doppler visualization of the posterior interosseous vessels were mandatory. All flaps were risen under 3.5x-4.5x magnification. Results: all flaps survived completely in 3 weeks postoperatively. There were no postoperative complications such as flap’s arterial or venous insufficiency, deep infection, or posterior interosseous nerve palsy. Nearly whole group (9 of 10) of patients and/or their parents were satisfied with the esthetic view of the reconstructed hand and donor site of the forearm 1 year postoperatively. Conclusion: posterior interosseous flap is a reliable and versatile option in pediatric hand reconstructions, providing excellent skin coverage with good color match and texture. Preservation of major vascular bundles of the forearm (radial and ulnar arteries) during flap harvest gives a possibility to perform a simultaneous microsurgical reconstructions of the hand (e.g. free toe transfer).

About the authors

I. O. Golubev

Priorov Central Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: iog305@mail.ru
Russian Federation

V. M. Grishin

Peoples’ Friendship University of Russia

Email: vmgrishin@yandex.ru
Russian Federation

References

  1. Пинчук В.Д. Предплечье как донорская область для аутопластики сложными кожными лоскутами на сосудистой ножке [автореф. дис. ... канд. мед. наук]. Л.; 1989. 24 с
  2. Родоманова Л.А., Кочиш А.Ю. Реконструктивные микрохирургические операции при травмах конечностей. СПб.: РНИИТО им. Р.Р. Вредена; 2012. 116 с
  3. Родоманова Л.А., Полькин А.Г. Реконструктивная микрохирургия верхней конечности. Травматология и ортопедия России. 2006; 42(4): 15-19
  4. Canales F., Lineaweaver W.C., Furnas H. et al. Microvascular tissue transfer in paediatric patients: analysis of 106 cases. British Journal of Plastic Surgery. 1991; 44(6): 423-427.
  5. Costa H., Soutar D.S. The distally based island posterior interosseous flap. British Journal of Plastic Surgery. 1988; 41(3): 221-277.
  6. Costa H., Cunha C., Conde A., Gracia M.L., Vranchx J., Soutar D. The posterior interosseous flap: a review of 81 clinical cases and 100 anatomical dissections - assessment of its indications in reconstruction of hand defects. British Journal of Plastic Surgery. 2001; 54(1): 28 - 33.
  7. Costa H., Pinto A., Zenha H. The posterior interosseous flap - a prime technique in hand reconstruction. The experience of 100 anatomical dissections and 102 clinical cases. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2007; 60(7): 740 - 747.
  8. Goubier J.N., Romana C., Masquelet A.C. Le lambeau interosseux postérieur chez l'enfant: une série de 13 cas. Chirurgie de la main. 2002; 21(2): 102-106.
  9. Lu L.J., Gong X., Lu X.M., Wang K.L. The reverse posterior interosseous flap and its composite flap: Experience with 201 flaps. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2007; 60(8): 876 - 882.
  10. Penteado C.V., Masquelet A.C., Chevrel J.P. The anatomic basis of the fascio-cutaneous flap of the posterior interosseous artery. Surgical and Radiology Anatomy. 1986; 8(4): 209 - 215.
  11. Tan O. Reverse posterior interosseous flap in childhood: a reliable alternative for complex hand defects. Annals of Plastic Surgery. 2008; 60(6): 618 - 622.
  12. Upton J., Havlik R.J., Coombs C.J. Use of forearm flaps for the severely contracted first web space in children with congenital malformations. Journal of Hand Surgery. 1996; 21(3): 470 - 477.
  13. Upton J., Coombs C.J. The Hypoplastic and Absent Thumb. In: Principles and Practice of Pediatric Plastic Surgery. Ed. by Bentz M.L., Bauer B.S., Zuker Ronald M.Z. St. Louis, Missouri: Quality Medical Publishing, Inc.; 2008. Vol. 2, Part III.
  14. Zancolli E.A., Angrigiani C. Colgajo dorsal de antebrazo (en "isla"): (pediculo de vasos interosseos posteriores). Revista Asociacion Argentina Ortopedia Traumatologia. 1986; 51: 161 - 168.

Copyright (c) 2014



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies