Moving car-tire injury of the foot is a condition that appears to be a new clinical entity in Istanbul, in which the non-weight-bearing surface of the foot is prone to be injured. Between 1992 and 1995, eight moving car-tire injuries of the foot were managed. Patient age averaged 10.25 years (range: 7 to 21 years). All patients presented with soft-tissue loss combined with extensor tendon and bone lesions. In 6 patients, immediate flap coverage after initial debridement and, in 2 patients, delayed coverage after multiple debridements, were performed. All the flaps survived. Although in all patients, the weight-bearing region was always intact, some had gait-pattern abnormalities due to the bone and soft-tissue injuries. Early removal of all devitalized tissues and closure of the wounds with transfer of healthy tissue have a higher rate of success, lower incidence of infection, require fewer operative procedures, and shorter hospitalizations.
Various flaps have been described for the reconstruction of the soft tissue defects of the digits, but these are not applicable to all kinds of defects. Moreover, these techniques are mostly 2-staged operations that require long-term immobilization. In this study, reverse-flow digital artery cross-finger flap was used to cover various volar and dorsal digital defects in 9 cases. Seven of 9 cases that had follow-up period longer than 2 years were evaluated, and all had good results. We recommend that reverse-flow digital artery cross-finger flap is a universal flap that can be used for almost all types of soft tissue defects of the digits.
Twenty-one cases of skin defects of the hand were treated with venous flaps. According to type, nine flaps were arterialised flaps (A-A), five were (A-V), and seven were (V-V) type. Venous flaps can be used up to 8 x 3 cm in size or even bigger if the number of veins anastomosed is increased. The main advantage of venous flaps is that they can also be used for simultaneous reconstruction of circulation in digits.
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