Introduction: Mutilating injuries of the hand that occur
due to different types of trauma could produce soft tissue
defects with, or without bone, tendons, and joint injuries. It
is a challenge to reconstructive plastic surgeon.
Patients and Methods: Forty nine patients presented by
hand soft tissue defects. The Patients were divided according
to the procedure done into three groups: Posterior interosseous
artery (PIA) flap (Group I), reversed radial forearm (RRF)
flap (group II) and abdominal flap (group III).
Results: Post-operative DASH score and follow up period
in abdominal flap operated group were significantly higher
than that operated by PIA flap "group I" and "group II".
Cosmetic evaluation of patients in group I was significantly
higher than that of RRF flap, and abdominal flap. There was
a postoperative significant improvement of the angle of first
web space in comparison to preoperative angle in six cases
operated for contracture of the first web space. The postoperative
complications in PIA flap operated group were 21.05%,
and 27.78% in RRF flap operated group. In abdominal flap < br />operated group 78.95% of cases showed complications.
In Conclusion: Reconstructive plastic surgeon should
have the capability and plasticity in dealing with soft tissue
defects of the hands, with best recruitment of the available
local forearm flaps, and distant flaps. Each patient should be
individually studied and well counseled before the choice of
the proper reconstructive method.