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Abstract

Background: Complex digital extensor tendoninjuries are difficult to manage when adhesionformation and stiffness prevail. Vascularised tissueto reconstruct the skin and extensor defect wouldbe the ideal reconstruction in both the acute anddelayed settings. This anatomical study evaluatesvascular supply to a suitable composite flapcomprising skin, subcutaneous tissue and extensorretinaculum.Methods: An anatomical study of 18 cadaveric upperlimbs was conducted to investigate the technicalfeasibility of a composite flap prior to its clinicalapplication. The anterior (n=9) or posterior (n=9)interosseous artery was exposed and selectivelyinjected with a coloured dye. Specimens werethen dissected to raise the proposed compositeflap of extensor retinaculum and the overlyingintegument. Specimens were subsequently assessedby digital subtraction angiography to evaluate thecorresponding microvascular supply to the compositeflap.Results: The anterior and posterior interosseousarteries supplied the extensor retinaculum througha dense network of vessels with choke anastomoses.The skin overlying the extensor retinaculum waspredictably supplied by either artery through theperforator vessels between the fourth and fifthextensor tendon compartments.Conclusion: A composite unit of skin and extensorretinaculum can be harvested on either the anterioror posterior interosseous arteries. It can be employedfor simultaneous vascularised tendon and skinreconstruction.

Item Type:	Article
Authors/Creators:	Sreedharan, S and Ross, RJ and Froelich, JJ and Cuellar, WA
Keywords:	tendons, tendon injuries, surgical flaps
Journal or Publication Title:	Australasian Journal of Plastic Surgery
Publisher:	Australian Society of Plastic Surgeons
ISSN:	2209-170X
DOI / ID Number:	https://doi.org/10.34239/ajops.v2n2.101
Copyright Information:	Copyright © 2019. Authors retain their copyright in the article. This is an open access article distributed under the Creative Commons Attribution Licence which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Related URLs:	UTAS Profile: Cuellar, WA
Item Statistics:	View statistics for this item

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