Versatility of the Reverse Dorsoulnar Fasciocutaneous Flap in Coverage of Hand Defects: Clinical Experience With 36 Cases

Uygur, Fatih; Uygur, Müjde; Ülkür, Ersi̇n; Sever, Celaletti̇n

doi:10.1016/j.jhsa.2009.04.002

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…[19] Dorsoulnar perforator flap is another regional alternative in soft tissue reconstruction. [20,21] Although this flap does not sacrifice the ulnar artery, the limited arc of rotation confines its use to only the proximal palm and ulnar side of the dorsal hand.…”

Section: Discussionmentioning

confidence: 99%

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Barin

Çinal

Kara³

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Reconstruction of the complex upper extremity defects is a challenging procedure for reconstructive surgeons because of the complex anatomical and functional structure of this region. In reconstruction, local and regional flap options involving the composite tissues are restricted. The posterior interosseous flap (PIO) has been presented "in a single study" with a wide variety of uses, and in this study, the versatility of PIO has been tried to be emphasized by its multitude uses as well as its chance at adaptability to each case. Hence, due to this, the objective to highlight the versatile utility of the PIO flap in clinical practice and to present a good option for the reconstruction of complex upper limb defects for various cases have been targeted. METHODS: We used 26 PIO flaps in 25 patients (18 male and seven female patients) with upper limb defects. The main etiological causes were burn contracture, traffic accident, firearm and acute burn injury. Twenty-two flaps were harvested as fasciocutaneous and four flaps as osteo-fasciocutaneous manner, which were applied to the metacarpal defects. In this study, 25 flaps were transferred as pedicled flaps, of which 23 and 2 flaps had reverse and antegrade blood flows, respectively, whereas one flap was used as a free flap. RESULTS: The mean follow-up period was 14 months. All flaps except one, which had partial necrosis and secondary healed, survived completely. All patients were able to gain basic functions for daily routine activities in the late postoperative period. Patients and/ or their parents were satisfied with the postoperative functional and aesthetic improvements. CONCLUSION: Many advantages of the PIO flap make it useful for the reconstruction of upper limb complex defects. It can be versatilely used based on changing its flow direction and enrichment of contents.

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Section: Discussionmentioning

confidence: 99%

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Barin

Çinal

Kara³

et al. 2019

Ulus Travma Acil Cerrahi Derg

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“…The DUA flaps make it possible to protect the main arteries from destruction and have a flap length of up to 20 cm and a flap width of up to 6 cm. [12][13][14][31][32][33] The vascularized corticocancellous graft obtained in this manner could largely cure metacarpal bone defects. Furthermore, the soft tissue component of the flap provides the skin cover.…”

Section: Discussionmentioning

confidence: 99%

“…With the inclusion of the descending branch, the pedicle length can reach up to 6 cm, and a pedicle diameter of 1.06 mm (0.65 to 1.64 mm) can be observed. [13] Subsequently, the pedicle can be extended by modification of the distal base. [14,15] In 2004, Choupina et al, [16] for the first time, illustrated how this applied as an osteocutaneous flap in a patient with a metacarpal bone and soft tissue defect.…”

mentioning

confidence: 99%

A different option in vascular bone grafts in the hand and wrist region: Use of a dorsoulnar artery-based osteo-fascio-cutaneous flap: A case series

Orman

Eren

Kara³

et al. 2021

Jt Dis Relat Surg

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Objectives: This study aims to describe our surgery technique and discuss patients treated through the dorsoulnar artery (DUA)-based technique of osseous and osteo-fascio-cutaneous vascularized ulnar bone grafting. Patients and methods: Between January 2011 and January 2015, six male patients (median age: 22.5 years; range, 20 to 24 years) who underwent surgery during which the technique of DUA ulnar bone graft was utilized. One patient with scaphoid nonunion, three patients with Kienböck’s disease, and two patients with a traumatic metacarpal defect were retrospectively evaluated. The joint range of motion (ROM), grip strength, Disabilities of the arm, shoulder and Hand (DASH) questionnaire score and Visual Analog Scale (VAS) score, and radiographies before and after surgery were examined. Scintigraphy was performed at 12 weeks postoperatively to monitor the viability of the bone graft. Results: All patients showed improvements in the ROM, grip strength, VAS, and DASH scores. According to the radiographic examination, bone union was achieved in all patients and the scintigraphy revealed that vascularization was detected in the bone tissue. Conclusion: The advantages of DUA-based vascularized bone graft are good bone quality and quantity and versatility due to its long pedicle. The osteo-fasio-cutaneous DUA flap seems to be effective in the treatment of traumatic metacarpal bone defects accompanied by skin loss. The DUA-based vascularized ulnar bone may be a source for scaphoid and lunate biological bone reconstruction.

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“…Currently, the pedicled flap remains a mainstay in hand soft tissue defect reconstruction [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] due to the reconstructive principle of 'like-with-like'. However, partial or total flap necrosis remains the main complication and has a relatively high incidence.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for pedicled flap necrosis in hand soft tissue reconstruction: a multivariate logistic regression analysis

Gong

Cui

Jiang

et al. 2017

ANZ Journal of Surgery

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Versatility of the Reverse Dorsoulnar Fasciocutaneous Flap in Coverage of Hand Defects: Clinical Experience With 36 Cases

Cited by 7 publications

References 18 publications

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

Versatile Use Of 'The Posterior Interosseous Flap' In The Reconstruction Of Complex Upper Limb Defects

A different option in vascular bone grafts in the hand and wrist region: Use of a dorsoulnar artery-based osteo-fascio-cutaneous flap: A case series

Risk factors for pedicled flap necrosis in hand soft tissue reconstruction: a multivariate logistic regression analysis

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