POSTERIOR INTEROSSEOUS FLAP IN RECONSTRUCTION SOFT TISSUE DEFECTS OF THE HAND

Abstract

Purpose: to asses and to analyze early and long-term results of the hand reconstructions of the extensive soft tissue defects with posterior interosseous flap of the patients with hand injuries. Objective: find out whether this type of operation is optimal for the reconstruction of soft tissue defects of the hand; improve the quality of life of patients with soft tissue defects of the hand Materials and methods: the results of reconstruction of soft tissue defects of the hands with the posterior intercostal flap of the forearm in 6 patients (5 men and 1 woman) aged 31 to 67 years were analysed. In all 6 cases, reconstruction of the posterior interosseus flap was performed during the phased treatment of the patient with severe post-traumatic defects in the soft tissues of the hand. In all 6 cases, the reconstruction of soft tissue defects of the hands was combined with complex traumatic and orthopedic operations (autocost plasty with a cortical-spongiotic graft, removal or resection of one of the rays of the hand with the formalion of narrow – fingered hand, osteosynthesis and rheosynthesis by spokes, microscrews and microplates, necrectomy and amputations). Preoperative preparations included ultrasound Doppler of the forearm with visualization of posterior interosseus vessels. In all cases, reconstructive operations were performed using binocular optics with an increase of 30–35 times. In the postoperative period, the condition of vascularization of flaps was monitored by thermal imaging. Results: the flaps has taken root in all 6 cases. Postoperative complication in the form of marginal flap necrosis in it’s local venosus insufficiency was determined in one patient, which indicates the variability of vascular anatomy of the flap. Conclusion: 1 year after operation, all patients were satisfied with the function of the hand the aesthetic appearance of the hand and donor area on the forearm. Survey Disabilities of the Arm, Shoulders, and Hand (DASH) was used to assess postoperative results in all patients after 1 year.