Introduction Raynaud phenomenon (RP) is an exaggerated vascular response to cold temperature or emotional stress, which manifests clinically as color changes in the fingers from white to blue to red. Primary RP (“Raynaud disease”) occurs in the absence of associated…
Indications One indication is loss of the thumb because of a traumatic injury ( Fig. 95.1 ). Although replantation of the amputated thumb is always considered first, there may be instances where the amputated digit is not viable or replantation…
Replantation refers to the reattachment of a completely amputated part of a digit, whereas revascularization is defined as repair of an incompletely amputated part that is nonviable and will experience necrosis without vascular repair. Indications The aim of digit replantation…
Introduction The venous flap is a thin, pliable flap consisting of skin, subcutaneous tissue, and veins. It differs from conventional flaps in that it is not an arterial afferent and venous efferent flap ( Fig. 93.1A ). Instead, inflow and…
Indications In both free antegrade and pedicled reverse designs, the lateral arm flap is useful for coverage and resurfacing of forearm, elbow, and dorsal hand wounds. It is thin, has fascia to provide a tendon gliding surface, and has a…
Introduction The pedicled groin flap is an axial vascular flap based on the superficial circumflex iliac artery (SCIA). As an axial flap, it can be designed to cover a larger length-width ratio than what is possible with random abdominal flaps.…
Introduction Three pedicled forearm flaps, including the reverse radial forearm flap, ulnar artery perforator flap (Becker flap), and posterior interosseous artery (PIA) flap, are commonly used for coverage of hand defects ( Table 90.1 ). TABLE 90.1 Pedicled Forearm Flaps…
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Introduction The dorsal metacarpal artery (DMA) flap is a vascularized skin flap from the dorsum of the hand. It can be based on the second, third, or fourth DMA and its cutaneous perforators. The flap also can be based on…
Introduction The thumb is an essential part of the hand and plays a key role in power and precision grip, together with the fingers. The major goals of thumb reconstruction vary from patient to patient, but may include maintenance of…