Thumb reconstruction with a wrap-around free flap in hand radiation injury

Jung Il Lee, Jung Ho Park, Jong Hoon Park, Yong Jin Kim, Jong Woong Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We describe a patient with hand radiation injury that was caused by 192Ir radiation source exposure. The cutaneous symptoms that appear after local radiation exposure follow a certain time pattern consisting of the prodromal, manifestation, subacute, chronic, and late stages. Although the clinical characteristics of each stage are well known, limited cases of photographic demonstrations to the progressive local radiation reaction have been reported. We demonstrate characteristics of serial necrotic changes in the fingers after radiation exposure in photographs. Initially, blisters, mild erythema, and swelling were present in the exposed fingers. However, at 3 years postexposure, total necrosis, severe flexion deformity, and bony exposure were present in the exposed fingers. For restoration of hand function, we performed a transmetacarpal, metacarpophalangeal, and transphalangeal amputation of the second, third, and fourth fingers, respectively. After debridement of the necrotic thumb tissue, a wrap-around free flap from the hallux was performed for thumb reconstruction. At 2 years postoperatively, the free flap survived well and graft bone union had occurred. The patient's hand function had improved such that he could grip a large object using the reconstructed thumb and the fifth finger.

Original languageEnglish
Pages (from-to)401-405
Number of pages5
JournalMicrosurgery
Volume32
Issue number5
DOIs
Publication statusPublished - 2012 Jul

ASJC Scopus subject areas

  • Surgery

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