Ulus Travma Acil Cerrahi Derg. 2018; 24(1): 43-48 | DOI: 10.5505/tjtes.2017.41196

Dorsal el defektlerinin yumuþak doku onarýmý için posterior interosseöz arter flebi ile ters akýmlý adipofasyal radyal ön kol flebinin kýyaslanmasý

Osman Akdað¹, Gökçe Yýldýran¹, Mustafa Sütçü², Mehtap Karameþe^1
1Selçuk Üniversitesi Týp Fakültesi, Plastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalý, Konya
²Medipol Üniversitesi Týp Fakültesi, Plastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalý, Ýstanbul

AMAÇ: Bu çalýþmadaki amacýmýz el dorsumundaki defektlerin posteriyor interosseöz arter flebi (PÝA) ve ters akýmlý adipofasyal radial önkol (RRÖF) ile onarým sonuçlarýný kýyaslamaktýr.
GEREÇ VE YÖNTEM: Geriye dönük olarak dizayn edilen bu çalýþmaya 2008–2013 yýllarý arasýnda, PÝA ile (11 hasta) ve RRÖF ile (12 hasta) el dorsumundaki yumuþak doku defektleri onarýlan 23 hasta dahil edildi. Onarým yöntemleri fonksiyonel olarak kol, omuz ve el sorunlarý anketi (DASH) skoru, eklem hareket açýklýðý (ROM) ile; estetik olarak skarýn görünümü ile deðerlendirildi. Ameliyat süreleri, hastanede kalýþ süreleri ve donör alan problemleri kýyaslandý.
BULGULAR: Posteriyor interosseöz arter flebi ve RRÖF arasýnda ROM ve DASH skorlarý ve hastanede kalýþ süresi açýsýndan istatistiksel açýdan fark saptanmadý. Ameliyat süreleri, skar deðerlendirmesi ve donör alan problemleri açýsýndan ise istatistiksel açýdan fark saptandý.
TARTIÞMA: Dorsal el defektlerinde RRÖF sonuçlarý PÝA’dan daha iyidir, ne varki RRÖF elin ana bir arterini sakrifiye etmektedir.

Anahtar Kelimeler: El yumuþak doku defekti, posterior interooseöz flep; ters akýmlý adipofasyal radial ön kolflebi; ters akýmlý radial ön kolflebi.

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Posterior interosseous flap versus reverse adipofascial radial forearm flap for soft tissue reconstruction of dorsal hand defects

Osman Akdað¹, Gökçe Yýldýran¹, Mustafa Sütçü², Mehtap Karameþe^1
1Department of Plastic, Reconstructive and Aesthetic Surgery, Selçuk University Faculty of Medicine, Konya-Turkey
²Department of Plastic, Reconstructive and Aesthetic Surgery, Medipol University Faculty of Medicine, Ýstanbul-Turkey

BACKGROUND: Our objective was to compare the outcomes of dorsal hand defect reconstruction using a posterior interosseous artery flap (PIAF) and a reverse adipofascial radial forearm flap (RARFF).
METHODS: From 2008 to 2013, 23 patients who underwent hand soft tissue defect reconstruction with PIAF (11 patients) and RARFF (12 patients) were included in this retrospective study. Reconstruction methods were compared in terms of functionality with disability of the arm, shoulder, and hand (DASH) score and range of motion (ROM) and aesthetically with scar assessment. Operation times, length of hospital stay, and donor site problems were compared.
RESULTS: We found no statistically significant differences between PIAF and RARFF in terms of ROM, DASH score, and length of hospital stay. Statistically significant differences were found in operation time, scar assessment, and donor site problems between PIAF and RARFF patients.
CONCLUSION: RARFF showed better results than PIAF in dorsal hand defects, but in RARFF, the major arteries of the hand are sacrificed.

Keywords: Hand soft tissue defect, posterior interosseous artery flap; reverse adipofascial radial forearm flap; reverse radial forearm flap.

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ATIF KOPYALA