2006 - UZ Leuven

cranial bone and dura which cannot be reconstructed with local flapsor skin grafts.Material and method: Free latissimus dorsi transfer was carried out in6 patients with subtotal and total scalp defects ( 4x reconstruction aftertumor removal, 1x tissue break down after irradiation, 1x defectreconstruction after high voltage injury). There were 2 male and 4female patients. The age ranged from 36 to 72 years. Reconstructionwas carried out with a muscle flap (1x) or a myo-cutaneous flap (5x)in combination with a split thickness skin mesh (1:1,5) graft, done in asingle-stage procedure. In a retrospective clinical study the followingcriteria were evaluated: 1) flap healing, 2) aesthetic result, and 3)complications.Results: All flaps healed primarily, and all wounds remained closedwithout any signs of infection. Complete wound healing was achievedafter 4 to 8 weeks, depending on the “take” of the skin grafts.Secondary skin grafting was necessary in 2 patients, revision of thedonor site in 1 patient. From an aesthetic point of view 4 patientscomplained about the appearance of the retroauricular skin island.After removal of the skin island 6 months after the initial operation, allpatient judged the result as good or acceptable.Conclusion: Free LD transfer is the only option for coverage ofsubtotal or total scalp defects. Contrary to most authors, our preferreddonor vessels are maxillary artery and the external jugular vein. Inorder to avoid any vascular compression we are using a myocutaneousflap. The skin island must be removed secondarily.HIERNER R., NIJS S. BERGER A.: Vascularized joint transfer for fingerjoint reconstruction: - currrent indications an long-term results. J. HandSurg., 2006; 31B: 37.Background: Vascularized complete joint transfer offers the uniquepossibility to reconstruct a joint defect at the thumb or fingers usingautologous tissue, which fully preserves its growth potential.Patients and methods: In a retrospective clinical study 14 vascularizedjoint transfers to the hand with an average follow-up of 8,2 (3 – 15)years were evaluated. The joint defect was caused by trauma in 11patients and infection, tumour and congenital deformity in 1 patienteach. There were 12 men and 2 women. The mean age range was 26(2 – 42) years. In 4 cases a partial vascularized joint transfer, and in10 patients a complete vascularized joint transfer was carried out. Thefollowing criteria were evaluated: active range of motion (Neutral-0-Method), postoperative arthritis, growth and complications.Results: Active range of motion of the transplanted joint was for partialPIP-joint transfer Ex/Flex 0/20°/65°, partial MP-joint transfer0/20°/30°, DIP-to PIP-joint transposition 0/20°/60°, PIP-to-PIP81