Transplantation of the Neurosensory Free Flaps to the Hand

Journal of the Korean Society for Surgery of the Hand 2000;9(2):120-126.
Published online November 30, 2000.

Jun-Mo Lee, M.D. and Ju-Hong Lee, M.D.

수부에 시행한 신경감각 유리 조직 이식술

이준모·이주홍

Abstract

  Microsurgical reconstruction of the hand demands recovery of the sensation of the reconstructed free flap as well as microsurgeon’s intelligence, technique and experience. Even with adequate soft tissue coverage and skeletal mobility, an insensate hand is prone to further injury and is unlikely to be useful to the patients.
   Authors have performed 8 cases of neurosensory free flaps in the hand, 4 cases of wrap around, 3 dorsalis pedis and 1 lateral arm flap, from July 1992 through June 1999 and followed up average 4 years and 4 months.
   Wrap around flap was performed for reconstruction of 4 cases of thumb, repairing deep peroneal nerve and superficial radial nerve by epineurial neurorrhaphy, and followed up for average 3 years and 10 months and calculated 9㎜ in the static 2 point discrimination test.
   Dorsalis pedis flap were 3 cases for reconstruction of the ray amputation, extensor tendon exposure and wrist exposure. Deep peroneal nerve and branch of the ulnar nerve was repaired by epineurial neurorrhaphy calculating 6㎜ and superficial peroneal nerve and superficial radial nerve averaging 18㎜ in the static 2 point discrimination test for follow up average 2 years and 9 months.
   Lateral arm flap was 1 case for reconstruction of the ray amputation in the hand repairing posterior cutaneous nerve to the arm to the superficial radial nerve calculating 20㎜ for follow up 6 years and 8 months.

Key Words: Neurosensory free flaps, Wrap around flap, Dorsalis pedis, Lateral arm