| Objective:To investigate the applied methods and effects of the chimerical osteocutaneous perforator flap with superficial circumflex iliac artery for reconstruction of metacarpalbones and skin defect in hands.Methods: From February 2011 to April 2014. Six patients in whom bone metacarpalbones and skin defect in hands were reconstructed with free chimerical osteocutaneous perforator flaps using superficial circumflex iliac vessel. Including 5 males and l female with an average age of 30 years. Of 6 patients 4 were used for the reconstruction of composite the first metacarpal bone and soft tissue defects. 2 for the second metacarpal bone and soft tissue defects. The area of cutaneous deficiency was about 4.0cm×2.0cm~11.0cm×5.0cm. The size of osseous flaps ranged from 5.0 cm~8.0 cm. and the size of cutaneous flaps ranged from 6.0cm×3.0 cm to l2.0 cm×6.0 cm. All the arteries were reconstructed by end to end anastomoses between the donor iline artery and the recipient artery except one.which was periormed using an end to side method.The bone flaps were fixed with the Kirschner wire(4case),and aid of plate and screw(2cases).Results:All flaps survived. No Vascular crisis occurred.All wounds of the donor site healed within 8 to 27 days.All the cases were followed up for 6 to 13 months.the appearance of flaps was satisfactory and no special protection was needed.All bone defects healed during a period time of 1.5 to 2.5 months.No patient complained of pain at the donor site. The function of hand prehension was completely recovered, and thumb opposition was partly recovered.Conclnsion:The chimerical osteocutaneous superficial circumflex iiiac free perforator flap can minimize the donor site complication and is suit able for the recons- truction of metacarpalbones and skin defect in hands. Therefore is one of the ideal methods to repair metacarpalbones and skin defect of the hands. |
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