Table Of ContentSoft Tissue Reconstruction
of the Hand: Loco-regional
and Distant Flaps Selection
and Approach
Obaid Almeshal
Salah Aldekhayel
Feras Alshomer
Editors
123
Soft Tissue Reconstruction of the Hand:
Loco-r egional and Distant Flaps Selection
and Approach
Obaid Almeshal • Salah Aldekhayel
Feras Alshomer
Editors
Soft Tissue Reconstruction
of the Hand: Loco-regional
and Distant Flaps Selection
and Approach
Editors
Obaid Almeshal Salah Aldekhayel
Division of Plastic Surgery, Department of Division of Plastic Surgery, Department of
Surgery, King Abdulaziz Medical City Surgery, King Abdulaziz Medical City
Ministry of National Guard - Health College of Medicine, King Saud bin
Affairs. King Abdullah International Abdulaziz University for Health
Medical Research Center Sciences Ministry of National
Riyadh, Saudi Arabia Guard - Health Affairs. King Abdullah
International Medical Research Center
Feras Alshomer Riyadh, Saudi Arabia
Division of Plastic Surgery, Department of
Surgery, King Abdulaziz Medical City
Ministry of National Guard - Health
Affairs. King Abdullah International
Medical Research Center
Riyadh, Saudi Arabia
ISBN 978-981-16-9944-3 ISBN 978-981-16-9945-0 (eBook)
https://doi.org/10.1007/978-981-16-9945-0
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore
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This book is dedicated to the outstanding
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All of your hard work has paid off.
Special thanks to my family, my wife,
and my kids
Preface
It has been a sincere privilege to write and edit this book directed toward hand,
plastic, and reconstructive surgeons. It addresses different levels of expertise rang-
ing from medical students interested in the field to expert hand surgeons.
Most of the books and articles related to this field are either quite extensive and
do not show the clinical scenario being managed or tunneled to the problem being
discussed. This will lead to ambiguity and unclarity of the problem being managed,
especially for young surgeons.
In this book, the reader will learn the different solutions related to hand soft tis-
sue coverage options presented in an anatomical fashion and well-illustrated figures
followed by a case scenario. The book was written in a bullet point fashion that
discusses flap selection in easy-to-follow surgical steps, including postoperative
instructions. The book will provide the reader with a solution related to hand soft
tissue coverage that avoids the need for challenging microvascular skills.
Riyadh, Saudi Arabia Obaid Almeshal, MBBS, SB-Plast
vii
Acknowledgments
Special thanks are due to Dr. Abdullah Al-Thunayan, Dr. Abdullah Al-Namla and
Professor Mohammad Al-Qattan, who provided unlimited support and had a
tremendous impact as great mentors. Additionally, many thanks to Dr. Hanan
Alhusainan who participated in the management and care of the patients.
ix
Contents
Part I Random Flaps
1 Z-Plasty Flap and Its Variants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Bushra Alhazmi and Mohammed Alfawzan
2 Four-Flap Z-Plasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Bushra Alhazmi and Mohammed Alfawzan
3 Limberg (Rhomboid) Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Malak Alsaif and Mohammed Alfawzan
4 Rotational Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Malak Alsaif and Mohammed Alfawzan
5 Bilobed Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Malak Alsaif and Mohammed Alfawzan
6 Y to V Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Malak Alsaif and Mohammed Alfawzan
7 V to M Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Malak Alsaif and Mohammed Alfawzan
8 Simple Transposition Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Malak Alsaif and Mohammed Alfawzan
Part II F inger tip Flaps: V-Y Advancement Flaps
9 (Atasoy) Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Muhammad Majid Ul Haq and Mohammed Alfawzan
10 Bilateral V-Y (Kutler) Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Muhammad Majid Ul Haq and Mohammed Alfawzan
11 Oblique Triangular (Venkataswami) Flap . . . . . . . . . . . . . . . . . . . . . . . 51
Hazqeel Solangi and Mohammed Alfawzan
12 Segmüller Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Maher Elnahas and Mohammed Alfawzan
xi
xii Contents
Part III Finger-Related Flaps
13 Standard Cross-Finger (Cronin) Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Hassan abbas Ali and Turki Alhassan
14 Reverse Cross-Finger Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Hassan abbas Ali and Turki Alhassan
15 C-Ring Cross-Finger Flap (Turkist Flap) . . . . . . . . . . . . . . . . . . . . . . . . 73
Hassan abbas Ali and Turki Alhassan
16 Dorsal Middle Phalangeal Finger Flap (DMFF) . . . . . . . . . . . . . . . . . . 77
Ahmed T. Al Turki and Turki Alhassan
17 Intercomissural Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Ahmed T. Al Turki and Turki Alhassan
18 Homodigital Bipedicled Island Advancement (O’Brien) Flap . . . . . . . 89
Ahmed T. Al Turki and Turki Alhassan
19 Homodigital Quadrangular Flap (Heuston Flap) . . . . . . . . . . . . . . . . . 93
Ezekwe E. Amirize and Turki Alhassan
20 Souquet Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Ezekwe E. Amirize and Turki Alhassan
21 Thenar Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Anas M. Alyamani and Turki Alhassan
22 Reverse Vascular (Neurovascular) Pedicle Digital Island Flap . . . . . . . 109
Syed M. Ammar Yasir Jaffry
23 Quaba Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Ezekwe E. Amirize and Turki Alhassan
Part IV Thumb-Related Flaps
24 Moberg Volar Advancement Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Anas M. Alyamani and Abdulaziz Alhujayri
25 Neurovascular Island Pedicled (Littler) Flap . . . . . . . . . . . . . . . . . . . . . 125
Asmaa Z. Bin Mahmoud and Abdulaziz Alhujayri
26 Annular Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Asmaa Z. Bin Mahmoud and Abdulaziz Alhujayri
27 First Dorsal Metacarpal Artery Flap and Its Variants
(Foucher’s Kite, Helovich’s Racquet Flap, and Bilobed First
Dorsal Metacarpal Artery Flap) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Asmaa Z. Bin Mahmoud and Abdulaziz Alhujayri
Contents xiii
28 Reverse Dorsoradial “Moschella” Flap. . . . . . . . . . . . . . . . . . . . . . . . . . 139
Bushra Alhazmi and Abdulaziz Alhujayri
29 Reverse Dorsoulnar or Dorsocubital “Brunelli” Flap . . . . . . . . . . . . . . 143
Bushra Alhazmi and Abdulaziz Alhujayri
Part V Pedicled Flaps: Regional Flaps
30 Adipo-Fascial Flaps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Abdullaziz S. Alazzam and Abdulaziz Alhujayri
31 Finger Propeller Flaps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Ali I. Hadadi and Abdulaziz Alhujayri
32 Dorsal Island Digital (Axial) Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Abdullaziz S. Alazzam and Nawaf Alohaideb
33 Reverse Radial Forearm Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Abdulaziz Alshenaifi and Nawaf Alohaideb
34 Radial Artery Perforator Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Abdulaziz Alshenaifi and Nawaf Alohaideb
35 Fillet Flap (Amputation Cases) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Anas M. Alyamani and Feras Alshomer
36 Reverse Posterior Interosseous Artery Flap . . . . . . . . . . . . . . . . . . . . . . 183
Nawaf Alohaideb
37 Dorsal Ulnar Artery Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Nawaf Alohaideb
Part VI P edicled Flaps: Distant Flaps
38 Thoracoabdominal Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Ali I. Hadadi and Nawaf Alohaideb
39 Abdominal Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Ali I. Hadadi and Nawaf Alohaideb
40 Groin Flap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Ali I. Hadadi and Nawaf Alohaideb
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
