Single-stage reconstruction of high-voltage electric burns sequelae of volar forearm using nerve grafts, short tendon grafts and microvascular flap

Abstract

Introduction: A total of 10 patients underwent single-stage reconstruction of high-voltage electrical burn sequelae at the distal forearm and volar wrist, in patients with complete loss of motor and sensory function of the hand; all 10 were operated using interposition tendon grafts for the flexor digitorum profundus, nerve grafts for the median and ulnar nerves and the anterolateral thigh flap (ALT) for coverage; in addition, the fascial component of the flap was used to wrap the repaired finger flexors. Materials and Methods: All the flaps survived, and eight of the 10 patients had S3 or S4 recovery of median nerve sensation. Results: The final outcome measurement was done by adopting a variant of the abbreviated upper extremity functional index. The mean value for this was 19 of a possible 40 points (range in 10 patients −7 to 28). Discussion: Single-stage reconstruction using short tendon grafts and nerve grafts is a useful procedure in high-voltage electrical burns. Conclusion: The use of the ALT with vascularised fascia permits early finger flexor activity suitable for activities of daily living.