Abstract
Managing infections of bony structures in the digit, especially in cases where the overlying soft tissue is damaged or the patient is immunocompromised, remains challenging. Although many reports have documented the efficacy of muscular and fascial flaps, few local flaps are available for affected hands. We herein report two complicated cases of purulent arthritis or osteomyelitis occurring in the interphalangeal joint of the hand. The patient underwent intrinsic adipofascial flap transfer to the actively affected joints, subsequently achieving prompt infection control and finally achieving functional and aesthetic healing of the hands. Clinical results suggest that intrinsic adipofascial flaps are extremely effective in controlling active infections of deep tissue in digits with few donor-site morbidities.
(A) Meticulous sequestrectomy was performed. The flexor pollicis longus was taped (left). A design of two adipofascial flaps (right). (B) A cross-digital adipofascial flap and a reverse second metacarpal flap were elevated and transferred to the defect. (C) A schematic illustration of the surgery.
