Combining traditional and microsurgical reconstruction after a complex hand trauma with multiple tissue defects. A case report

Main Article Content

Francesco Messana
Diego Faccio
Sandro Rizzato
Paolo Marchica
Franco Bassetto
Vincenzo Vindigni
Cesare Tiengo

Abstract

 

Complex injuries involving bones, tendons and soft tissues of the hand still represent a difficult challenge for reconstructive surgeons. Hereby, we present a case of a man suffering from a complex crush injury of the right hand that led to a wide three-dimensional defect with loss of two metacarpal bones, extensor tendons and skin.


For composite hand defects, the most common surgical approach provides for a one-stage composite reconstruction or for an early restoration of bone and skin, with delayed tendon grafts. For the peculiarity of the defect, a one-stage reconstruction was not feasible. Hence, we opted for a two-stage reconstruction but the usual surgical steps have been inverted.


First we secured tendon and skin restoration through a composite teno-cutaneous radial free flap. A month later, we reconstructed the two metacarpals with a modified Masquelet technique using fibular cortical graft. This strategy allowed the patient to start an early rehabilitation program and obtain a satisfactory recovery of his dominant hand.


 

 


 

Article Details

How to Cite
Messana, Francesco, et al. “Combining Traditional and Microsurgical Reconstruction After a Complex Hand Trauma With Multiple Tissue Defects. A Case Report”. Annali Italiani Di Chirurgia, vol. 10, no. July, July 2021, pp. 1-5, https://annaliitalianidichirurgia.it/index.php/aic/article/view/736.
Section
Case Report
Author Biographies

Francesco Messana, Clinic of Plastic Surgery, University of Padua; Padua, Italy

 

 

     

Diego Faccio, Clinic of Plastic Surgery, University of Padua; Padua, Italy

 

 

     

Sandro Rizzato, Clinic of Plastic Surgery, University of Padua; Padua, Italy

 

 

     

Paolo Marchica, Clinic of Plastic Surgery, University of Padua; Padua, Italy

 

 

     

Franco Bassetto, Clinic of Plastic Surgery, University of Padua; Padua, Italy

 

 

     

Vincenzo Vindigni, Clinic of Plastic Surgery, University of Padua; Padua, Italy

 

 

     

Cesare Tiengo, Clinic of Plastic Surgery, University of Padua; Padua, Italy