Soft tissue coverage in a crush injury of the hand in a patient with sickle cell anemia
Keywords:
crush injuries, muscle flaps, posterior interosseous artery flap, sickle cell anemia.Abstract
We report the case of a crush injury to the right hand in a patient with a clinical history of sickle cell anemia. Reconstruction was performed with a groin flap, followed by a posterior interosseous artery flap and an anterolateral thigh flap. The treatment of these injuries was complex due to the need for specialized soft tissues, which are difficult to reproduce for large defects in the palm of the hand. In addition, the degree of development of scar tissue leads to contractures and difficulties in the functional use of the hand and fingers. This case was aggravated by the patient's history of sickle cell anemia.
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Senda H, Muro H, Terada S, Okamoto H. A case of degloving injury of the whole hand reconstructed by a combination of distant flaps comprising an anterolateral thigh flap and a groin flap. J Reconstr Microsurg. 2011;27(5):299-302. DOI: https://doi.org/10.1055/s-0031-1278708
Doctor AM, Mathew J, Ellur S, Ananthram AA. Three-flap cover for total hand degloving. J Plast Reconstr Aesthetic Surg. 2010;63(4):e402-5. DOI: https://doi.org/10.1016/j.bjps.2009.10.007
Zelken JA, Chang NJ, Wei FC, Lin CH. The combined ALT-groin flap for the mutilated and degloved hand. Injury. 2015;46(8):1591-6. DOI: https://doi.org/10.1016/j.injury.2015.05.022 Epub 2015 May 20.
Lin TS. One-stage debulking procedure after flap reconstruction for degloving injury of the hand. J Plast Reconstr Aesthetic Surg. 2016;69(5):646-51. DOI: https://doi.org/10.1016/j.bjps.2016.01.012
Rab M, Prommersberger KJ. Distally pedicled posterior interosseous artery flap for the coverage of defects on the wrist and hand. Oper Orthop Traumatol. 2008;20(2):111-8. DOI: https://doi.org/10.1007/s00064-008-1234-x
Spence RJ. The use of a free flap in homozygous sickle cell disease. Plast Reconstr Surg. 1985;76(4):616-9. DOI: https://doi.org/10.1097/00006534-198510000-00026
Abraham PF, Allam O, Park KE, Alperovich M. Microsurgery in the sickle cell trait population: Is it actually safe? BMJ Case Rep. 2020;13(5):e234924. DOI: https://doi.org/10.1136/bcr-2020-234924
Cooper L, Seth R, Rhodes E, Alousi M, Sivakumar B. Free tissue transfer in patients with sickle cell disease: Considerations for multi-disciplinary peri-operative management. J Plast Reconstr Aesthetic Surg. 2017;70(1):12-24. DOI: https://doi.org/10.1016/j.bjps.2016.10.005
