Recent Trends for Reconstruction of Post Traumatic Dorsal Hand Defects

Abstract

The hand is a very special organ, with unique functions and versatility in the human body. Our hands are pivotal in manipulating our environment, receiving feedback from our surroundings and communicating our unspoken words by gestures. Thus the loss of the hand is a tragic, disfiguring event with profound personal, vocational, financial and social implications. The dorsal skin is more vulnerable to injury than volar skin, due to it’s thinness, it’s loose adherence to the underlying structures and due to the constant flexed position of the hand in rest and also in function. The main advantages of skin grafts are that they are rapid and easy procedures. The main disadvantages are their limitation to well vascularized bed with no exposed tendons, bone. Local axial flap have the advantages of having good vascularity, wide arc of rotation, applicability in exposed tendons and bones, allows early rehabilitation and better cosmetic appearance. The distant flaps have the advantages of being easy and rapid technique, well established applicability for coverage of both dorsal and palmar surfaces. Their main disadvantages are the multistaged procedure and prolonged period of immobilization.