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Kirschner Wire Fixation for Immobilization of the Thenar Flap in an Uncooperative Pediatric Patient: A Case Report

Archives of Hand and Microsurgery 2020년 25권 4호 p.287 ~ 291
유효경, 김영훈, 권성택, 김병준,
소속 상세정보
유효경 ( Yoo Hyo-Kyung ) - Seoul National University College of Medicine Seoul National University Hospital Department of Plastic and Reconstructive Surgery
김영훈 ( Kim Yung-Hoon ) - Seoul National University College of Medicine Seoul National University Hospital Department of Plastic and Reconstructive Surgery
권성택 ( Kwon Sung-Tack ) - Seoul National University College of Medicine Seoul National University Hospital Department of Plastic and Reconstructive Surgery
김병준 ( Kim Byung-Jun ) - Seoul National University College of Medicine Seoul National University Hospital Department of Plastic and Reconstructive Surgery

Abstract


Thenar flap is a commonly used operational method in fingertip reconstruction. It should be maintained for 2 to 3 weeks before flap division until the neovascularization is established from the fingertip to the flap. However, immobilization between two stages of operation is challenging especially in uncooperative pediatric patients. A 47-month-old female with a ring fingertip amputation underwent soft tissue reconstruction with thenar flap. Two days postoperatively, the flap’s proximal margin was found disrupted. Flap revision was performed, followed by applying a transphalangeal Kirschner wire (K-wire) between the thumb proximal phalanx and ring finger middle phalanx. The flap was successfully divided two weeks after the original operation. The result was aesthetically pleasing, and no complication was observed, including dehiscence, necrosis, limitation of range of motion, and visible scar of the pinning sites. In conclusion, K-wire fixation is a safe and effective method to immobilize thenar flap in uncooperative pediatric patients.

키워드

Surgical Flaps; Bone wires; Fingers; Immobilization; Pediatrics

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