Đánh giá kết quả ứng dụng vạt cánh tay ngoài trong điều trị khuyết hổng phần mềm vùng cổ tay và bàn tay

Abstract

Objective: To assess the outcomes of using the free lateral arm and extended lateral arm flap in the treatment of the tissue defect of the forearm and hand. Subject and method: The 46 flaps of 45 patients with soft tissue defects at the forearm and hand that were covered by free lateral arm flaps. Patient outcomes include: Flap surival, healing process, functional recovery and aesthetic appearance at both the recipient and donor sites, flap extention practicability and sensory recovery. Result: The maximum size of the flap was 16cm × 10cm and minimum size 7cm × 5cm. The 32 lateral arm flaps extended over the lateral epicondyle of the humerus were 10cm in maximal length and 3cm in minimal length (average: 7.13 ± 1.99cm). The rate of survival flap was 45/46. The cause failure of vascular obstruction of the anatomosis. The patients defect in this case was treated, thereafter, by a second successful reconstruction using an anterior lateral thigh flap. The wound healing at the recipient and donor sites occurred favorably in all cases. Sensitive reinnervacion was performed in 26 lateral arm flaps that were used for covering the defects of the palmar region of the wrist and hand; in the cases the sensitive recovery was assessed as S3⁺ in 20 patients and S3 in 6 patients at 24 months after the operation respectively. The majority of the patient were content with the post-operative functional and aesthtic result at the recipient and donor site. Conclusion: The free lateral arm flap is a good option for the reconstrucion of the soft tissue defects at the forearm and hand; the flap may be safely extended to a distal level of 7.13cm from the lateral epicondyle of the humerus