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The composite extensor retinaculum cutaneous flap: an anatomical cadaveric study


Sreedharan, S and Ross, RJ and Froelich, JJ and Cuellar, WA, The composite extensor retinaculum cutaneous flap: an anatomical cadaveric study, Australasian Journal of Plastic Surgery, 2, (2) pp. 51-57. ISSN 2209-170X (2019) [Refereed Article]

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Copyright Statement

Copyright 2019. Authors retain their copyright in the article. This is an open access article distributed under the Creative Commons Attribution Licence which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.

DOI: doi:10.34239/ajops.v2n2.101


Background: Complex digital extensor tendon injuries are difficult to manage when adhesion formation and stiffness prevail. Vascularised tissue to reconstruct the skin and extensor defect would be the ideal reconstruction in both the acute and delayed settings. This anatomical study evaluates vascular supply to a suitable composite flap comprising skin, subcutaneous tissue and extensor retinaculum.

Methods: An anatomical study of 18 cadaveric upper limbs was conducted to investigate the technical feasibility of a composite flap prior to its clinical application. The anterior (n=9) or posterior (n=9) interosseous artery was exposed and selectively injected with a coloured dye. Specimens were then dissected to raise the proposed composite flap of extensor retinaculum and the overlying integument. Specimens were subsequently assessed by digital subtraction angiography to evaluate the corresponding microvascular supply to the composite flap.

Results: The anterior and posterior interosseous arteries supplied the extensor retinaculum through a dense network of vessels with choke anastomoses. The skin overlying the extensor retinaculum was predictably supplied by either artery through the perforator vessels between the fourth and fifth extensor tendon compartments.

Conclusion: A composite unit of skin and extensor retinaculum can be harvested on either the anterior or posterior interosseous arteries. It can be employed for simultaneous vascularised tendon and skin reconstruction.

Item Details

Item Type:Refereed Article
Keywords:tendons, tendon injuries, surgical flaps
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Surgery
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Sreedharan, S (Dr Sidha Sreedharan)
UTAS Author:Cuellar, WA (Dr William Cuellar)
ID Code:136432
Year Published:2019
Deposited By:Medicine
Deposited On:2019-12-19
Last Modified:2020-04-30
Downloads:12 View Download Statistics

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