22. THE LATERAL ANTEBRACHIAL NEUROFASCIOCUTANEOUS FLAP WITH DETECTING THE LOCATION OF THE DISTAL PERFORATORS OF THE RADIAL ARTERY FOR HAND SOFT TISSUE DEFECTS RECONSTRUCTION
Main Article Content
Abstract
Background and objectives: There is still no consensus among researchers regarding the pivot point of the distally based lateral antebrachial neurofasciocutaneous flap, using for coverage of hand soft tissue defects. Therefore, this study aimed to determine the approriate location of the distal perforators of the radial artery as the pivot point of the lateral antebrachial neurofasciocutaneous flap.
Materials and Methods: The prospective case series study applies the lateral antebrachial neurofasciocutaneous flap with detecting the location of the distal perforators of the radial artery for reconstruction of hand soft tissue defects with exposed tendon or bone. All cases were followed up at least 6 months.
Results: Thirty-three flaps (33/35) were survived (94,3%). Two flaps (02/35) suffered from distal superficial necrosis. The pivot point was located above the radial styloid process: 4 cm (26 flaps), 6 cm (9 flaps). The flap can cover many sides of hand, without complication and sequel.
Dicussion: Detecting the location of the distal perforators of the radial artery is the important step in harvesting the lateral antebrachial neurofasciocutaneous flap for reconstruction of hand soft tissue defects.
Conclusions: The distally based lateral antebrachial neurofasciocutaneous flap with detecting the location of the distal perforators of the radial artery is useful for coverage of hand soft tissue defects, without complication and sequel.
Article Details
Keywords
The distally based lateral antebrachial neurofasciocutaneous flap.
References
limb coverage: experience with 44 clinical cases.
The Journal of hand surgery. 1997;22(3):515-
526.
[2] Shi-min C, Chun-Lin H, Feng Z et al., Distally
based radial forearm flap with preservation of
the radial artery: anatomic, experimental, and
clinical studies. Microsurgery. 2003;23(4):328-
337.
[3] Nguyễn Anh Tuấn, Một số nhận xét về các
vạt da cuống ngoại vi vùng cẳng tay trong che
phủ mất da bàn tay; Y học TP Hồ Chí Minh.
2004;8(1):47-50.
[4] Michel SC, Mirsad M, Corrine W et al., The radial
artery pedicle perforator flap: vascular analysis
and clinical implications. Plastic Reconstructive
Surgery. 2010;125(5):1469-1478.
[5] Wael HM, Radial forearm flap versus
radial adipofascial perforator based flap for
reconstruction of hand soft tissue defects.
Donnish Journal of Medicine and Medical
Sciences. 2015;2(3):19-25.
[6] Nguyễn Tấn Bảo Ân, Vạt da cân thần kinh bì
cẳng tay ngoài cuống ngoại vi che phủ khuyết
hổng mô mềm cổ bàn tay; Tạp chí Y Dược thực
hành 175. 2019;19.
[7] Thepparat K, Chanakarn R, Tulyapruek T et al.,
The lateral antebrachial neurocutaneous flap:
A cadaveric study and clinical applications;
Journal of Reconstructive Microsurgery.
2020;36(07):541-548.
[8] Andrew MH, James C, Radial artery
perforator flap; The Journal of hand surgery.
2010;35(2):308-311.
[9] Susan EM, A. Lee Dellon, The overlap pattern
of the lateral antebrachial cutaneous nerve and
the superficial branch of the radial nerve; The
Journal of Hand Surgery. 1985;10A:522-526.
[10] Steven B, Dan AZ, Charles PM et al., Anatomy of
the lateral antebrachial cutaneous and superficial
radial nerves in the forearm: a cadaveric and
clinical study; The Journal of hand surgery.
2005;30(6):1226-1230.