Versatility of Local Fasciocutaneous Flaps for Coverage of Soft Tissue Defects in Upper Extremity

Abstract

Appropriate soft tissue coverage is of paramount importance for coverage of bone, joint, tendons, neurovascular structures, and hardware in upper extremity. In this article we have tried to renew the importance and simplicity of using the local fasciocutaneus flaps for coverage of shoulder, elbow and hand joints with showing the techniques in three examples. During a 5year period,from 2004 to 2009, we have been treating soft tissue defects of the upper extremity over joints and hardware with local fasciocutaneous flaps. During this time we had 50 cases of exposed hardware, 20 over shoulder joint and 30 over olecranon. Also, we had 100 cases of exposed joints,30 over shoulder, 45 over olecranon 10 over wrist and 15 over finger joints. The etiology of exposed joints were 60 cases from burn, 10 from bursitis, 20 from traumatic injuries and the rest from other injuries such as animal bites.In this article we present 3 cases with the technique of operations and their associated figures: one exposed hardware at the shoulder treated by a distally based local fasciocutaneous flap,one exposed elbow joint due to flame burn treated by antecubital flap and the third case exposed bone and joint in the fifth and an example of fourth fingers treated by local fasciocutaneous flap from the same fingers. In these 150 cases we had 6 cases of superficial necrosis of the flaps which healed with supportive therapy. There was no cases of complete necrosis. 27 patients underwent revision of the dog-ear and were completely satisfied with the result. we present our experience of 150 case to prove that local fasciocutaneous flaps are versatile and can be used with good results if properly planned.