Abstract
There are many methods available for soft tissue coverage of traumatic thumb injuries. Some of them allow coverage of volar surface and some dorsal surface only. Although these surgical procedures allow for coverage of the defect, but have the major drawback of donor site morbidity, limited tissue for cover or complexity of procedure. We present an observational study of 10 cases of traumatic thumb injuries including volar, dorsal and circumferential tissue loss and also failed FDMA flaps managed with groin flap- a technically easier procedure with reliable blood supply and limited donor site morbidity and hidden donor site scar. In our study ipsilateral groin flap was used in patients with complete/incomplete volar or complete/incomplete dorsal soft tissue loss as well as in patients with circumferential loss. Groin flap was also used as a salvage procedure for the patients who had loss of FDMA flap. All patients regained adequate function of their hand with acceptable cosmetic results and no donor site morbidity. We conclude that groin flap can be used for partial or total soft tissue loss for volar as well as dorsal soft tissue loss and for circumferential tissue loss too. Groin flap although, does require the immobilization of arm for three weeks and are bulky which may require thinning of flap and many a times more than once but it is not demanding surgically, avoids donor site cosmetic morbidity, provides ample cover of tissue loss of thumb.
References
- David C. C. Chuang, L. H. Colony, C. Chert, F. C. Wei. Groin Flap Design and Versatility. Plast Reconstr Surg. 1989, 84(1):100-7.
- Nardi Kola. Thumb Reconstruction Using Foucher’s Flap.Maced j Med Sci. 2016; 4(1): 70–73.Service of Burns and Plastic Surgery, UHC Mother Teresa, Tirana, Albania
- McGregor IA, Morgan G. Axial and random Pattern flaps. Br J Plast Surg. 1973; 26: 202.
- Smith PJ: The vascular basis of axial patternflaps. Ibid, p 150
- Gordon H. Knutson, The groin flap:A new technique to repair traumatic tissue defects.CMA Journal.1977;116:622-5.
- Smith PJ, Foley B, McGregor IA, et al.The anatomical basis of the groin flap. PlastReconstr. Surg. 1972;49: 41.
- Chuang DC, Colony LH, Chen HC, Wei FC. Groin flap design and versatility. Plast Reconstr Surg. 1989;84:100–7. [PubMed]
- Harii, K., Obmori, K., Torii, S., et al. Free groin skin flaps. Br. J. Plast. Surg. 1975;28: 225.
- O’Brien, B. M, Morrison, W. A, Ishida, H, etal. Free-flap transfers with micro vascular anastomoses.Br. J. Plast. Surg.1974 27: 220.
- Serafin, D, and Buncke, K.J. (Eds.) Groin Flap. InT. Jackson (Ed.), Microsurgical Composite Tissue Transplantation.St. Louis: Mosby, 1979: 231-43.
- Taylor G. I, and Daniel R. K. The anatomy ofSeveral free-flap donor sites. Plast. Reconstr. Surg.1975 56:243.
- Ohmori K., and Harii K. Free groin flaps: Theirvascular basis. Br. J. Plast. Surg.1975; 28: 238.
- Goertz O, Kapalschinski N, Daigeler A, Hirsch T. The effectiveness of pedicled groin flaps in the treatment of hand defects: Results of 49 patients. J Hand Surg Am. 2012;37:2088–94. [PubMed]
- Voulliaume D, Mojallal A, Comparin JP, Foyatier JP. Brûlures graves de la main etlambeaux: choixthérapeutiques et revue de la littérature. Ann Chir Plast Esthet. 2005;50:14–319. [PubMed]
- Li YY, Wang JL, Lu Y, Huang J. Resurfacing deep wound of upper extremities with pedicled groin flaps. Burns. 2000;26:283–88. [PubMed]
- Guiga M, Fourati MK, Meherzi A, Belhassine H. Notre expérience des lambeauxinguinauxpédiculés à propos de quatre-vingtscas. Ann Chir Main. 1988;7:79–84. [PubMed]
- Kashiwa K, Kobayashi S, Ogino K, Kashiwaya G, Higuchi H. Inferolateral extension of the groin flap based on the artery accompanying the lateral femoral cutaneous nerve. J Reconstr Microsurg. 2009;25(3):181–189. [PubMed]
Corresponding Author
Dr Waseem Mushtaq Syed
Department of Surgery, SKIMS, Jammu and Kashmir, India
House no. 02, sector J-2, Irm Lane, Natipora, Srinagar, Jammu and Kashmir, India
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