Autologous Fat Grafting in the Upper Extremity: Defining New Indications

Abstract

Background: Autologous fat grafting is a commonly used technique in plastic surgery that can also be applied broadly in hand surgery. We present a case series to demonstrate the diverse indications for fat grafting in hand surgery. Methods: We retrospectively reviewed cases of fat grafting in the upper extremity in 2020. Cases representing a unique application of fat grafting were identified. Patient data, including demographics, diagnoses, preoperative and postoperative assessments, complications, patient satisfaction, and surgical operative reports, were recorded. Results: Five patients representing distinct indications for autologous fat grafting in the upper extremity were identified. Indications included hand rejuvenation (20.0%), burn/scar management (20.0%), tenolysis (20.0%), revision nerve decompression (20.0%), and carpometacarpal joint arthritis (20.0%). Average patient age was 60.4 years (range, 42–71). Average volume of fat injected was 15.2 ml (range, 1–37 ml). No major complications were noted (0.0%). All patients expressed satisfaction with their overall result with good functional outcomes (100%). Conclusions: Autologous fat grafting can be applied broadly in hand surgery. Indications for fat grafting in hand surgery include hand rejuvenation, burn/scar management, tenolysis, revision nerve decompression, and thumb carpometacarpal arthritis. Hand surgeons can easily incorporate fat grafting into their daily practice. Current literature supports fat grafting as a viable technique in hand surgery with lower-level studies.

An immunohistochemical and biomechanical evaluation of the effect of fat graft on tendon healing

“…In addition, some clinical studies have shown that fat grafting used in tendon repairs reduced adhesions and it has been recommended as a method with a positive effect on outcomes especially in flexor tendon repairs. 19,20 Thus, local adipose tissue grafting has been shown to be an easy-to-apply, low-cost method that provides successful results. 13 In the current study, for the first time in literature, the application of fat graft, which is a low-cost, easy-to-apply, and easily accessible method, was used in experimental tendon healing.…”