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Journal of the Korean Society for Surgery of the Hand 2004;9(4):292-298.
Published online December 1, 2004.
Revisit of the Utilities and Indications of Reversed Radial Forearm Flap for Hand Reconstruction
Kyung Chul Kim, Gi Jun Lee, Joo Sung Kim, Sang Hyun Woo
수부 재건을 위한 역행성 도서형 요측 전완부 피판의 유용성과 적응증의 재조명
김경철, 이기준, 김주성, 우상현
During the last ten years, the authors performed 86 cases of reversed radial forearm island flap for hand reconstruction. Retrospectively, based on the authors’clinical experiences, we would like to revisit the utilities and indications of this flap for hand reconstruction. The most common cause of the defect was caused by crush injury in 61(71%) cases. The most common recipient site was the dorsal aspect of the hand in 37 cases and the composition of fasciocutaneous pattern of the flap was 55 cases. The number of innervated and tendocutaneous flap was 15 and 6 cases, respectively. There were 6 cases of osteocutaneous flaps for the thumb reconstruction. Even though there were 2 cases of venous insufficiency, all flaps survived without any marginal necrosis. There was partial loss of skin graft on the donor sites in 6 cases, but they were healed after secondary procedure. The radius fracture in donor site, permanent paresthesia or anesthesia, or any circulatory disturbance of hand did not happen. We would like to suggest the limited indications of the reversed radial forearm island flap for hand reconstruction regarding to the morbidities of the donor sites or disadvantages of this flap. The first indication is for the reconstruction of the composite tissue defects including phalangeal or metacarpal bone with soft tissue defect of the thumb and other fingers. The second is single stage reconstruction of the hand with composite tissue defects with tendon or nerve irrespective of the bone involvement. The third is for the soft tissue reconstruction in congenital deformities of infants or traumatic defects of the young children or elderly people. The fourth is fasical or fasciocutaneous flap for the reconstruction of the degloved fingers. The fifth is for the failed cases of the reconstruction with other island flaps. The sixth indication is for the secondary use of the transferred radial artery and veins which is for secondary flap. If the donor site is possible to close primarily, the reversed radial forearm flap can be used for soft tissue reconstruction.

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