Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Aug 21;99(34):e21837.
doi: 10.1097/MD.0000000000021837.

Repair of soft tissue and extensor tendon defects on the dorsum of the hand by transfer of dorsal foot flap and extensor digitorum brevis tendon in a 3-year-old child: A case report

Heng Tian  1 , Debiao Song  2 , Hongjuan Jin  3 , Quanzhe Liu  1 , Yongheng Zhao  4 , Xuejie Wang  1 , Wenrui Qu  1 , Rui Li  1
Affiliations
Case Reports

Repair of soft tissue and extensor tendon defects on the dorsum of the hand by transfer of dorsal foot flap and extensor digitorum brevis tendon in a 3-year-old child: A case report

Heng Tian et al. Medicine (Baltimore). .

Abstract

Rationale: Repair of soft tissue defects on the dorsum of the hand with accompanying tendon defects is a challenging problem in clinical practice.

Patient concerns: Here, we describe the case of a 3-year-old boy with a 1-week old soft tissue injury with infection due to a soft tissue defect on the dorsum of his right hand, and further describe its treatment.

Diagnosis: A diagnosis of a soft tissue defect of the dorsum with extensor tendon defects in the fore, middle, ring, and little fingers of the right hand was made.

Interventions: The defects were repaired using a dorsal foot flap combined with the extensor digitorum brevis tendon, under spinal anesthesia, and a small dose of the sedative phenobarbital (Lumina) was administered via pump injection after the surgery.

Outcomes: The patient was followed-up for 6 months. The shape of the dorsal hand flap recovered satisfactorily and the skin color was almost normal. Protective sensation was restored and the tendon graft functioned well in vivo. Satisfactory outcomes were achieved in the flexion and extension of each finger.

Lessons: This case study provides evidence that for soft tissue defects on the dorsum of the hand with tendon defects, 1-stage transfer of a dorsal foot flap with the extensor digitorum brevis tendon can be effective for recovery of appearance and extensor function. In case of infant patients, postoperative use of low-dose sedation can effectively reduce the risk of vascular crisis, thus promoting survival of the flap graft, and ensuring the success of the operation.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
(A) The dorsum of the hand showed poor granulation tissue growth and an infected wound 1 wk after the injury; (B) The dorsum of the hand after using the VSD device indicated that the wound surface condition was improved 2 wk after the injury; (C, D) The dorsum and palm of the hand before surgery showed that the wound surface was ruddy, with granulation tissue growing well and uniformly, and there was no sign of infection. VSD = vacuum sealing drainage.
Figure 2
Figure 2
(A, B) Dorsal and ventral view of the free dorsal plantar artery combined with the extensor digitorum brevis tendon; (C). After loosening the tourniquet, the flap was ruddy in color and blood supply was good; (D) The appearance of the transferred dorsal foot flap combined with extensor digitorum brevis tendon on the dorsum of the hand.
Figure 3
Figure 3
The transferred flap survived and showed movement of extensor muscles in each finger 2 wk after surgery.
See this image and copyright information in PMC

References

    1. Chu G, Vlok L, Zwaag-Pijls C, et al. Emergency department management and follow-up of children with bicycle spoke injuries. J Emerg Med 2014;47:259–67. - PubMed
    1. Segers M, Wink D, Clevers G. Bicycle-spoke injuries: a prospective study. Injury 1997;28:267–9. - PubMed
    1. Caroli A, Adani R, Castagnetti C, et al. Dorsalis pedis flap with vascularized extensor tendons for dorsal hand reconstruction. Plast Reconstruct Surg 1993;92:1326–30. - PubMed
    1. Demirtas Y, Neimetzade T, Kelahmetoglu O, et al. Comparison of free muscle and perforator skin flaps for soft tissue reconstruction of the foot and ankle. Foot Ankle Int 2010;31:53–8. - PubMed
    1. Agha RA, Borrelli MR, Farwana R, et al. The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg 2018;60:132–6. - PubMed

Publication types