Management of soft tissue defects of hand with local (posterior interosseous) flaps

Abstract

Design:-Observational case series study Objective: - To evaluate the role of Local Flaps in the management of the soft tissue injuries of hand. Suit & Period: -. Study was conducted at BV Hospital, Bahawalpur from June 2002 to May 2003. Material & Method: - In this study, we selected cases in which direct skin closure was not possible due to large defect or skin grafting was contraindicated for example in cases where bones and tendons were exposed, or in certain conditions where some secondary procedures may have to be carried out like tendon repair, tendon grafting nerve repair or fixation of fracture. Patients with severely crushed, non-salvageable hands, manageable with primary suturing & skin grafts & Patients with peripheral vascular disease, Elderly diabetic & Patients medically unfit for anesthesia. Results: A total of 10 patients were treated between June 2002 and May 2003. There were 8 males and 2 females (male to female ratio 4:1). Mean age of the patients was 26.26 years with range between 10 and 60 years. Most common cause of skin defects was agriculture machine injury (6 cases) followed by roadside accidents (2 cases), blast injury (I cases), and electric burn (1 cases). In 7 patients there was an uneventful recovery. One flap was lost completely, partial flap loss occurred in one case, marginal necrosis and infection noted in one case. Conclusion: -Local (posterior interosseous island) flaps are useful for coverage of the skin defects over the hand when applied with proper indications.