Finger Joints Reconstructive Coverage with Cross-Arm (Colson) Flaps After Burn Injury: A Literature Review and Our Experience

Healthcare, vol. 13, pp. 3114

Abstract

Background: Random pattern flaps are widely used in reconstructive surgery when inadequate vascularity precludes skin graft survival or when regional pedicled flaps are unavailable due to local burn injury. Here, thin tissue from the upper arm was utilized to cover exposed cartilage over the proximal interphalangeal (PIP) joints of the contralateral hand. Methods/Technical Note: We report the uncommon application of multiple cross-arm (Colson) flaps to reconstruct dorsal skin defects over the PIP joints of the index, middle, and ring fingers following a high-voltage burn injury, in conjunction with a comprehensive literature review. Results: Three separate random-pattern flaps were harvested from the upper arm and transferred to the contralateral hand. All flaps demonstrated good perfusion, durable coverage, and a clean wound bed postoperatively, with preservation of joint mobility. Conclusions: To our knowledge, this represents one of the first reported reconstructions of multiple adjacent PIP joints using individual cross-arm flaps. This technique remains a dependable salvage option that should be considered in complex reconstructive scenarios when local or microsurgical options are not feasible.

Authors 5

1. Ziyad Alharbi corresponding

   Soliman Fakeeh Hospital · Fakeeh College for Medical Sciences

   Affiliation as printed

   Clinical Sciences Department, Fakeeh College for Medical Sciences, Jeddah 21461, Saudi Arabia

   Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah 21461, Saudi Arabia

2. Maysaa A. Alghamdi

   University of Jeddah

   Affiliation as printed

   College of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia

3. Johannes Hertelendy
   Affiliation as printed

   Department of Plastic and Reconstructive Surgery, Florence-Nightingale Hospital, 40489 Düsseldorf, Germany

4. Khalid Khatib Aachen Department of Plastic Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Plastic Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany

5. Norbert Pallua
   Affiliation as printed

   Plastic Surgery Elite, Pallua Clinic, 40212 Düsseldorf, Germany