Abstract

MARTINEZ MARTINEZ, F.  and  GUERRERO NAVARRO, M.L.. Vascularized tendocutaneous dorsalis pedis flap: case report. Cir. plást. iberolatinoam. [online]. 2013, vol.39, n.2, pp.167-171. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922013000200009.

Serious trauma of the hand usually involves the injury of several types of tissue. Lesions such as open wounds, fractures, tendinous damage and cutaneous defects frequently occur. This type of injuries represents an important challenge to reconstructive surgeons. Different approaches could be described in order to solve them: A) multiple stage procedures, B) parcial vascularization one-stage procedures, C) full vascularization one-stage procedures. Two stage techniques involve a first approach to perform a suitable cutaneous coverage and a second step in order to place tendon graft. This may cause joint stiffness and miscalculation of the final tendon length due to late muscular retraction and adherences. Dorsalis pedis flap has been historically well known as a choice of coverage for skin defects. However, some authors refuse to perform this as a free flap due to several issues, among them: the variability of the vascular anatomy, the difficulty of dissection and the high morbidity of the donor site. Nonetheless, the tendocutaneous dorsalis pedis free flap provides four tendons covered by a fully vascularized epitenon surface which is at the same time attached to a very thin skin surface, similar to the dorsum of the hand. This technique causes a much lower incidence of tendon adherences in comparison to the non vascularized tendon grafts procedure. We present a case of serious trauma of the dorsum of the hand which involved a complete disruption of the extensor tendons.

Keywords : Hand trauma; Dorsalis pedis flap; Extensor digitorum longus; Extensor tendons.

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