Background: Use of fascio-cutaneous or fascial flaps are
well known methods of reconstruction of dorsal hand defects
to preserve the gliding movement of the extensor tendons.
Whilst reconstruction of large hand defects extending to the
wrist or the distal forearm entails use of larger flaps with
large donor sites, so muscle flaps may have an advantage over
the fascial or fascio-cutaneous flaps in coverage of these large
defects. The aim of this study is to compare the gliding of the
extensor tendons underneath fascio-cutaneous and muscle
flaps on the dorsum of the hand.
Patients and Methods: The study included 20 patients
with dorsal hand trauma with exposed extensor tendons, ten
defects were reconstructed by free muscles flap and split
thickness skin graft and the other ten were reconstructed with
fascio-cutaneous flaps. Early rehabilitation in all cases was
done by a single dedicated physiotherapist. Tendon gliding
was assessed by measurement of active flexion and extension
at the metacarpo-phalangeal joint using goniometer after
complete flap healing four months following flap inset.
Results: There was no statistically significant difference
in gliding for extensor tendons in patients with hand defects
reconstructed by free muscle flaps and skin graft versus fasciocutaneous
flaps.
Conclusion: Both fascio-cutaneous and free muscle flaps
had comparable results concerning the extensor tendons gliding
underneath.