Journal of Japanese Society of Reconstructive Microsurgery
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
Original Article
Clinical Evaluation of Patients with Crush Wounds in the Dorsal Hand Requiring Soft Tissue Reconstruction
Yusuke KAMEDAMakoto MOTOMIYANaoya WATANABENorimasa IWASAKI
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2021 Volume 34 Issue 3 Pages 124-131

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Abstract

 We evaluated the clinical outcomes and treatment course in 8 patients with crush wounds in the dorsal hand that required soft tissue reconstruction. The mechanism of injury was crush injury in 7 cases and degloving injury in 1 case. The average time from injury to soft tissue reconstruction was 9 days (7?12 days) , except in 1 case in which a free anterolateral thigh (ALT) flap was performed 101 days after the initial injury. Free ALT flaps were applied in 7 cases and a reverse posterior interosseous artery flap was applied in 1 case. Four cases (11 affected digits) had complex injuries, including bone and/or tendon injury. In 3 of the 4 cases with complex injuries, 9 digits had severe contracture of the metacarpophalangeal joint with an arc <30 degrees. Complete rehabilitation was not achieved in these 3 cases due to inadequate bone fixation, insufficient debridement leading to infection, and inadequate soft tissue reconstruction. The clinical results of cases without bone/tendon injury were satisfactory when the appropriate soft tissue reconstruction was performed. Severe crush injuries of the bone/tendon often result in severe adhesion and contracture, and early rehabilitation, including adequate bone/tendon reconstruction and soft tissue reconstruction in the metacarpophalangeal joint-flexed position, is essential in such cases.

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© 2021 Japanese Society of Reconstructive Microsurgery
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