Free Dorsalis Pedis Flaps for Secondary Reconstruction of the Mutilated Hand

Abstract

Three cases of free flap transfers of dorsalis pedis flap were employed for secondary reconstruction of the mutilated hands. Case 1. A 22-year-old male sustained a heat press injury to his right hand, resulting in defect of skin and subcutaneous tissue of dorsum of the hand. The defect was grafted initially with split skin. The painful scar was developed on the dorsum of the hand after initial operation. Seven months after initial operation, free flap transfer was performed. Case 2. A 34-year-old male sustained a imcomplete amputation of his right hand involving the second to fifth finger at the mid palm with bone and soft tissue defect. All digids were successfully replanted, but severe flexion deformity was developed postoperatively. Six months after initial operation, free flap transfer with iliac bone grafting was performed. Case 3. A 35-year-old male sustained a roller injury to his right hand, resulting in degloving of the thumb and mid palm. The degloved segments were primarily replanted with microsurgical technique. All digids were successfully replanted, but the skin and soft tissue of the dorsum of the hand was defected. Four months after initial operation free flap transfer including long extenser of the foot in the flap was performed. In spite of the bad condition of the recipint beds, all of the transferred flaps were stable postoperatively and the hands were considerably relieved of the preoperative deformity.