gms | German Medical Science

Objectives/Interrogation: Fascia flaps have an important role in soft tissue reconstruction of the hand when tendons are exposed. Both free flaps and local fascia flaps are available to the hand surgeon. In this retrospective study patients requiring soft tissue reconstruction of the hand with fascial flaps were evaluated

Methods: 13 patients were identified, which underwent reconstruction of gliding surfaces or capsular structures with a fascial flap. In 6 patients the fascia only version of the posterior interosseous artery flap was used whereas in 3 cases a free temporoparietal fascia flap was applied. In 4 patients an ALT flap was used.

Results and Conclusions: All free flaps healed completely. In the local fascia flap into cases a distant tip necrosis developed which required repeated skin grafting. In one case persistent osteomyelitis required shortening arthrodesis. No amputations were necessary.

Fascia flaps embody a specific entity of flaps which are well applicable to soft tissue reconstruction of the hand were a thin and pliable reconstruction is mandatory. Although local options such as the fascia only intraosseous posterior flap are available, the microvascular tissue transfer has shown fewer complications in this series. Besides the ease of insetting, the available size of the free flap can be considered a major advantage.