Reversed osteocutaneous radial forearm island flap for traumatic thumb reconstruction

Abstract

Background: Loss of a part or whole of thumb results in severe functional compromise and needs to be rectified. Traumatic thumb loss requires careful evaluation of the problem and the patient as well, sound treatment and excellent surgical technique to secure a favourable outcome. We used reverse radial osteocutaneous flap for reconstruction of thumb defects. Methods: We witnessed almost similar nature of thumb injuries on the dorsal aspect with bone loss, in four carpenters over a period of one year. Reverse radial osteocutaneous flap was contemplated in all of them with good results. Results: All the flaps survived completely without donor site complications. We were able to give good functional and aesthetic results. All the patients were satisfied with the procedure and final outcome. Conclusions: The osteocutaneous variant of reverse radial forearm flap has a special place in reconstruction of thumb. This composite radial forearm osteocutaneous island flap eliminates the staging of procedures and has excellent vascularity.