Fingertip and Nailbed Injuries: Local Flaps-Surgical Skills Videos – Thenar Flap by Thomas Trumble. From Chapter 38: Soft Tissue Coverage of the Hand

Surgical Skills Videos – Thenar Flap by Thomas Trumble. From Chapter 38: Soft Tissue Coverage of the Hand - Hand Surgery Update IV. Published 2014.

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Video Transcription

Video Summary

This video discusses a case of finger reconstruction using thenar flaps. The patient has multiple degloving injuries on their index, middle, and ring finger, requiring coverage for the index and middle finger. Two separate thenar flaps are elevated for coverage. Since the defect is too large for primary flap closure, a split-thickness skin graft is harvested. The graft is meshed and used to cover the flap bed and the proximal portion of the fingers. Groin and abdominal flaps are avoided due to the patient's bilateral total knee replacement. The flaps are sutured into place, and the PIP joints are pinned to prevent tension. After three weeks, the flaps are divided and rotated into position. Some wounds may require later skin grafting, and range of motion exercises are started promptly. No credits given.

Keywords

finger reconstruction

thenar flaps

degloving injuries

split-thickness skin graft

range of motion exercises