VASCULARIZED FLAP FROM THE METACARPAL ARTERY TO THE LITTLE FINGER, DUE TO TRAUMATIC AMPUTATION: A CASE REPORT
Main Article Content
Keywords
Metacarpal artery, Reconstructive surgery, Vascularized flap
Abstract
Background, Defects of the soft tissues of the fingers are rare but catastrophic entities, associated with partial amputations of traumatic origin. When talking about the creation of a vascularized flap in the hand, one must take into account the difficulty involved in carrying out carrying out one of these procedures, due to the limited availability of donor tissues in the area, in this case the rotation of the metacarpal artery of the fourth space is performed, a rare procedure not documented in the country; Presentation of the case, we have a 21-year-old female patient, of mixed race, who suffers a traumatic amputation by hydraulic press, Allen classification IV; Expected conclusions, the reader should know the alternatives that can be carried out for the creation of vascularized flaps in the hand after traumatic amputations, in addition to knowing the technique to generate an impact and it can be used in other health homes.
References
2. Gonzalez Cely AM, Beltran Pardo AG, Miranda Diaz AJ, Garcia Rodriguez J, Alviar Rueda JD. Review and description of a classic technique of the first dorsal metacarpal artery flap. Vol. 45, Ibero-Latin American Plastic Surgery. Spanish Society of Reconstructive and Aesthetic Plastic Surgery (SECPRE); 2019. p. 295–305.
3. Wink JD, Gandhi RA, Ashley B, Levin LS. Flap Reconstruction of the Hand. Plast Reconstr Surg. on January 1, 2020; 145(1):172E–83E.
4. Webster N, Saint-Cyr M. Flaps Based on the Dorsal Metacarpal Artery. Vol. 36, Hand Clinics. W.B. Saunders; 2020. p. 75–83.
5. Athlani L, Dautel G. Skin coverage of the hand and fingers. EMC - Reconstructive and Aesthetic Plastic Surgery. June 2021; 29(1):1–23.
6. Bordianu A, Leoveanu FI. Hand soft tissue reconstruction with dorsal metacarpal artery perforator (Quaba) flap. J Med Life. January 1, 2021; 2021(5):731–6.
7. Żyluk A. Outcomes of coverage of the soft tissue defects in the hand with a groin flap. Polish Journal of Surgery. May 13, 2022; 94(4):1–5.
8. Li J, Luo X, Zou Y. Reconstruction of the Palmar Defect of the Hand with a Sensory Medial Plantar Artery Flap. Front Surg. May 6, 2022;9.
9. Tan RES, Lahiri A. Vascular Anatomy of the Hand in Relation to Flaps. Vol. 36, Hand Clinics. W.B. Saunders; 2020. p. 1–8.
10. Couceiro J, de Prado M, Menendez G, Manteiga Z. The First Dorsal Metacarpal Artery Flap Family: A Review. The Surgery Journal. October 2018; 04(04):E215–9.
11. Martí MR, Pérez M, Burgaya A, Calvet P, Gondolbeu A. Anatomy applied to flexor tendon surgery. Ibero-American Journal of Hand Surgery. November 2015; 43(02):128–34.
12. Vargas A, Chiapas-Gasca K, Hernández-Díaz C, Canoso JJ, Saavedra MÁ, Navarro-Zarza JE, et al. Clinical Anatomy of the Hand. Reumatol Clin. December 2012; 8(SUPPL.2):25–32.
13. Ferrin-Becerra GA, Cordoba-Chasoy AM, Osorio-Toro S. Dissection of the hand and its theoretical-practical relationship in rehabilitation: finding an anatomical variation*. Available in: https://doi.org/10.18041/1900-
14. Morro-Martí MR, Llusá-Pérez M, Forcada-Calvet P, Carrera A, Mustafa-Gondolbeu A. Anatomy Applied to Extensor Tendon Surgery. Ibero-American Journal of Hand Surgery. May 2019; 47(01):056–64.
15. So RES, Lahiri A. Vascular Anatomy of the Hand in Relation to Flaps. Vol. 36, Hand Clinics. W.B. Saunders; 2020. p. 1–8.
16. Gonzalez-Cely AM, Miranda-Diaz AJ, Alviar-Rueda JD, Forero PL. Atasoy flap: review of a classic technique for digital reconstruction. UIS Medical Journal. April 30, 2018; 31(1).
17. Weinzweig J, Weinzweig N. The "Tic-Tac-Toe" Classification System for Mutilating Injuries of the Hand. Plast Reconstr Surg. October 1997; 100(5):1200–11.
18. Gonzalez Cely AM, Beltran Pardo AG, Miranda Diaz AJ, Garcia Rodriguez J, Alviar Rueda JD. Review and description of a classic technique of the first dorsal metacarpal artery flap. Vol. 45, Ibero-Latin American Plastic Surgery. Spanish Society of Reconstructive and Aesthetic Plastic Surgery (SECPRE); 2019. p. 295–305.
19. Zepeda-Mora A, Sosa-Serrano de J, De la Torre-León G. Flap of the first dorsal metacarpal artery for thumb reconstruction. Plastic surgery. 2022; 32(3):129–33.
20. Posso Z C, Delgado A D, Aguilar H J, Vélez R D, Velásquez J. Perforating flap of the dorsal second metacarpal artery: Anatomical study in cadavers and clinical experience. Ibero-American Journal of Hand Surgery. May 2018; 46(01):003–11.
21. Galán R, Eliana Garcés G ; Versatility of the First Dorsal Metacarpal Artery Flap for Hand Coverage History of the Cerf Flap Volant. Vol. 20, RCCP. 2014.
22. Hernández Sosa V, Craviotto Corbellini M, Ripoll Munhó G, D'Oliveira Pazos L, Camacho García E. Reverse homodigital island flap for coverage of fingertip defects: case series. Ibero-Latin American Plastic Surgery. October 1, 2021; 47(4):425–34.
23. Villanueva A, from Ona I, de Oya A, López JI. Free flaps in hand surgery: our experience in 49 cases. Ibero-American Journal of Hand Surgery. November 2016; 44(02):097–105.