Extensor Tendon Gliding Surface Reconstruction Using Adipoascia Extended Free Anterolateral Thigh Flap: Case Report

Lee,  Sin Chul; Eun,  Seok Chan; Baek,  Rong Min

doi:2010.19.2.108

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Arch Hand Microsurg > Volume 19(2); 2010 > Article

Case Report

Journal of the Korean Society for Surgery of the Hand 2010;19(2):108-111.
Published online November 30, 2010.
DOI: https://doi.org/10.12790/jkssh.2010.19.2.108

Extensor Tendon Gliding Surface Reconstruction Using Adipoascia Extended Free Anterolateral Thigh Flap: Case Report

Sin Chul Lee, M.D., Seok Chan Eun, M.D., Rong Min Baek, M.D.

Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea. sceun@snubh.org

지방 근막 피판이 연장된 전외측 대퇴 유리 피판술을 이용한 신전건 활주막의 재건 - 증례 보고 -

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Abstract

Purpose: In reconstructing a defect on the dorsum of the hand, there are many cases of extensor tendons exposed or even missing. The repaired or reconstructed tendons need relevant gliding environment for good functional recovery. The anterolateral thigh flap offers a vascular fascial component with large amounts that can be used for covering exposed tendons and we report a unique case of single-stage hand dorsum and gliding surface reconstruction.
Methods: A 35-year-old man had severe post-traumatic scarring in his left dorsal hand and coverage of the flap with split-thickness skin graft has been done before. After scarred skin excision and extensor tendon graft for missed part, a free anterolateral thigh adipofascial flap was used to resurface the hand dorsum and to reconstruct a two-layer gliding surface of the extensor tendons. The extensor tendons were wrapped in the fascial component with the fat layer inside.
Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. Good overall functional recovery and tendon excursion were observed. He was also satisfied with postoperative appearance.
Conclusion: A free anterolateral thigh adipofascial flap was used successfully for reconstruction of a two-layer tendon gliding surface to treat a patient with severe scarring in the dorsal hand.

Key Words: Free flap, Gliding surface, Extensor, Anterolateral thigh flap

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