The Dorso-Radial Flap. A Useful Skin Flap for Hand Reconstruction

Joseph Bakhach, Dimitri Bakhach and Elias Zgheib

Department of Plastic and Reconstructive Surgery, Hand and Microsurgery, American University of Beirut Medical Centre, Lebanon

^*Correspondance to: Elias Zgheib 

 PDF  Full Text DOI: 10.25107/2474-1647.1574

Abstract

Background: Soft tissue defects on the dorsum of the hand are challenging to reconstruct and regional options with similar characteristics are limited. We thus report an original alternative, the dorso-radial flap, harvested from the distal quarter of the forearm dorsum and used to cover defects of the dorsum of the hand, first web space and thumb.Methods: Anatomic studies showed a direct cutaneous branch of the radial artery arising constantly at the level of the first intermetacarpal space’s apex, emerging directly or through a common trunk with the first dorsal metacarpal artery. These variations do not influence the operative technique or flap survival. A series of 12 clinical cases is reported. Four flaps were used to cover the MCP joint of the thumb, three were applied to resurface the first web space and the remaining five used to cover the hand dorsum and the MCP joints. The sizes of the dorso-radial flaps ranged from 4 to 7 cm in length and from 2 to 5 in width.Results: Follow-up ranged from three to six months with a mean of 4.8 months. All flaps survived and allowed enough skin coverage for the hand dorsum, underlying bones, joints and reconstructed tendons. Donor sites were closed primarily in two cases and grafted in the remaining ten. Functional outcomes were related to the associated bony and tendinous injuries.Conclusion: The dorso-radial flap is a direct anterograde flap. It is simple, reliable and useful in reconstructing soft tissue defects of the hand dorsum.

Keywords

Hand defect; Hand; Thumb; Forearm; Reconstruction; Skin flap

Cite the article

Bakhach J, Bakhach D, Zgheib E. The Dorso-Radial Flap. A Useful Skin Flap for Hand Reconstruction. Clin Surg. 2017; 2: 1574.