Combined free-tissue transfer for primary reconstruction of radial part of the hand.

This paper presents 14 cases of primary reconstruction of radial-part hand defect by combined free-tissue transfer. The thumb was reconstructed by wraparound flap or second-toe transfer, while a lateral upper-arm flap or anterolateral thigh flap was transferred to cover the soft-tissue defect of the radial part of the hand. The arteries of the toe and flap were anastomosed and cascaded with the radial artery in an anatomical "snuffbox." Fourteen toes and 13 flaps survived in 14 cases. Only one flap was lost. Two-point discrimination of thumb tips was between 4-8 mm. The results suggest that combined free-tissue transfer appears to be a promising way of reconstructing a defect of the radial part of the hand. Copyright 2004 Wiley-Liss, Inc.