EXTERNAL FIXATION FOR PROTECTION OF THE PEDICLE FLAP IN HAND INJURIES

In two patients large defects in the back of the hand were covered by pedicle flaps. A lower abdominal flap (groin flap) with an axial pattern of arterialization results in a thin flap with a width-to-length ratio of 1:2. Thin flaps show better aesthetic results, but these flaps must be protected by immobilization. Immobilization of an abdominal flap was easily achieved by external fixation of the wrist to the iliac crest. The advantages of external fixation are better wound care and flap observation and avoidance of cast-related complications. Removing the external fixation and cutting the predicle of the flap should always be accompanied by mobilization of the shoulder to avoid joint stiffness.