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Management of Hand and Digit Soft Tissue Injuries Using Free Fascia and Fasciocutaneous Flaps with Neo-Syndactylization

Fernando A Herrera, Brennan RBS, Karen M Horton, Charles K Lee, Rudolph Buntic and Gregory M Buncke

Traumatic hand and digit injuries result in complex challenging wounds that require the need for soft tissue coverage of exposed vital structures at the dorsal and palmar surface of the hand. Thin and supple tissue provides the best coverage for hand and finger defects because these tissues ultimately allow for stable wound coverage and improved range of motion with an acceptable aesthetic result. Given the limited amounts of expendable soft tissue in the distal upper extremity these devastating injuries usually require microvascular free tissue transfers with immediate syndactylization of the affected digits to provide soft tissue coverage. The authors review their experience in treating these complex hand and digit injuries using either free fascia or fasciocutaneous flaps with neosyndactylization of adjacent digits.