Arteria Dorsalis Pedis Free Flap for Dorsal Hand Defects: A Viable Reconstructive Option

Authors

  • Md Abdul Bari Khandakar Assistant Professor, Plastic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh.
  • Shammam Fayeka Assistant Register, ENT Oncology, National Institute of Cancer Research & Hospital, Mohakhali, Dhaka, Bangladesh.
  • Hasan Nazir Uddin Assistant professor, Plastic Surgery, Bangladesh medical college, Dhanmondi, Dhaka, Bangladesh.
  • Syed Md Sarwar Junior Consultant, Surgery, Dhaka Medical College Hospital.
  • Md Abul Kalam Professor and Director, Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.

DOI:

https://doi.org/10.3329/jss.v26i2.86102

Keywords:

Tissue Loss, Dorsum of Hand, Arteria Dorsalis Pedis flap, Free Flap, QuickDASH scale

Abstract

Background: The arteria dorsalis pedis (ADP) flap has been widely described in reconstruction of soft tissue loss over dorsum of hand. However, some details require refinement to improve functional results.

Methods: From August 2018 to July 2020, 20 patients (13 males and 7 females), mean age 29 years (range, 18-48 years) with soft tissue loss over dorsum of hand were treated with ADP Free Flap. Fasciocutaneous flaps were used for patients with only soft tissue defects. All flaps were sensate. After reconstruction of the defects, functional outcomes were evaluated with the Quick DASH scale.

Results: One flap was lost. 19 (95%) flaps survived. Average flap thickness of 4.9 mm underwent innervation by an end-to-end neurorrhaphy. On basis of methodology parameters, flap reconstruction was exhibited 65% excellent, 30% good and 05% poor. QuickDASH scale was used for motor function evaluations and the average percentage of disability was found 19.73%. Average 09 months follow up, perception of pain and touch was present in all patients. Temperature in 84.22% patients on the entire flap and two-point discrimination was showed 16.42±5.04 mm in the proximal half and 18.52±4.35 mm in the distal half of flap. No patient experienced difficulty walking.

Conclusions: Simultaneous thinning and innervation of the ADP flap led to a good functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function.

Journal of Surgical Sciences 2022;26(2): 60-67

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Published

2026-04-13

How to Cite

Khandakar, M. A. B., Fayeka, S., Uddin, H. N., Sarwar, S. M., & Kalam, M. A. (2026). Arteria Dorsalis Pedis Free Flap for Dorsal Hand Defects: A Viable Reconstructive Option. Journal of Surgical Sciences, 26(2), 60–67. https://doi.org/10.3329/jss.v26i2.86102

Issue

Vol. 26 No. 2 (2022)

Section

Original Articles

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