Soft Tissue Reconstruction of the Hand and Arm-Case: Soft Tissue Reconstruction

Case: Soft Tissue Reconstruction

Pdf Summary

The document discusses a case of a 55-year-old man who sustained injuries to his hand when it got caught in a truck salt spreader. The injuries included bony fractures as well as a full-thickness skin flap on the dorsal hand with intact extensor tendons. During bony fixation, it was discovered that the radial artery was badly contused but the hand was still well-perfused. The skin flap was repaired without tension, but the soft tissue wound remained after the fractures healed. The patient is a heavy smoker, which can negatively impact wound healing. <br /><br />The document then asks about potential treatment options for this soft tissue wound. <br /><br />The appearance of the hand after debridement is shown, and the options for treatment are discussed. An anterolateral thigh (ALT) free flap is chosen for robust coverage of the soft tissue defect. However, intraoperatively, it is found that there is no retrograde flow through the ulnar artery, which is consistent with previous findings of a badly contused radial artery. <br /><br />The summary of the document states that initial soft tissue debridement and bone stabilization are important. The choice of soft tissue coverage options depends on the area and structures involved in the injury. The use of pedicle and free flaps depends on sufficient inflow and outflow outside the zone of injury.

Keywords

55-year-old man

hand injuries

truck salt spreader

bony fractures

full-thickness skin flap

dorsal hand

extensor tendons

radial artery

soft tissue wound

wound healing