FREE FLAPS IN THE RECONSTRUCTION OF HAND AND DISTAL FOREARM INJURIES

We report a series of 32 free flap reconstructions following acute hand and forearm trauma. The series consists of two dorsalis pedis flaps, four scapular flaps and 26 lateral arm flaps. One gap became infected and failed completely, and a partial necrosis occurred in another flap. The transfers covered large shin defects, exposed tendons, tendon grafts, bone, bone grafts, jointa, nerves and nerve grafts. ‘Ihe donor site morbidity was negligible. Our study shows that free microvascular flaps are a safe and convenient alternative to conventional flaps in hand surgery. The lateral arm flap seems very suitable for small and medium size defects. Journal of Hand Surgery (British VoIume, 1992) I7B: 185-188 Severe hand and distal forearm injuries with tissue loss have traditionally been repaired with conventional flaps such as the groin flap, the abdominal flap and the delto-pectoral flap. However, during the last decade it has become obvious that microvascular free tissue transfer may solve many of the problems of reconstruction of upper extremity defects in one single stage. The compar