الفهرس 
ANATOMYOnly 14 pages are availabe for public view
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Abstract
Soft tissue defects of the hand are commonly encountered in the setting of trauma,
infection, or burns and after resection of tumors. Hand injuries can have devastating and
long-term social and economic consequences, affecting not only an injured individual’s
health and functioning, but also hindering his or her family’s livelihood and society as a
whole.
Early coverage of soft-tissue defects of the hand following trauma or tumor
resection with well vascularized flaps can provide an excellent functional outcome
Advances in perforator flaps enable surgeons to harvest thin, pliable, and wellvascularized
cutaneous flaps with minimal donor-site morbidity.
Our study was done on 49 patients presented by hand defects and deformities. Age
of patients ranged from 2years to 67 years, 37 patients were males.
Trauma was the cause of hand defects and deformities in 43 patient, burn was the
cause in 4 cases and only 2 patients suffered from congenital deformities
Patients were divided into 2 main groups: first group 21 patients with hand defects
and deformities reconstructed by micosurgical flaps, (4 free ALT flap, 4 DUAP flap, 7
Quaba flap, 3 PUDAP flap and 3 DDAP flap). 19 flaps were successful with superior
aesthetic outcomes of regional perforator flap. However, free flap has the advantage of
coverage large hand defects surface area. Flap venous congestion was the main
complication. Functional outcomes were better in traumatic and congenital cases than
post-burn cases. Second group involved 28 patients with 32 amputated fingers. Crush
injury was the most common mechanism of finger amputation.
Survival rate was higher in sharply amputated fingers than crushed-avulsed ones.
Venous compromise was the main cause of replantation failure. Functional recovery was poorer in more proximal amputations due to tendon adhesions and joint stiffness.