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Reconstruction of a Long Defect of the Ulnar Artery and Nerve with an Arterialized Neurovenous Free Flap in a Teenager: A Case Report and Literature Review

2018-02Journal article Open access
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dc.contributor.authorCasal, D
dc.contributor.authorPais, D
dc.contributor.authorMota-Silva, E
dc.contributor.authorPelliccia, G
dc.contributor.authorIria, I
dc.contributor.authorVideira, P
dc.contributor.authorMendes, MM
dc.contributor.authorGoyri-O'Neill, J
dc.contributor.authorMouzinho, MM
dc.date.accessioned2019-03-13T15:13:41Z
dc.date.available2019-03-13T15:13:41Z
dc.date.issued2018-02
dc.description.abstractThere is evidence that nerve flaps are superior to nerve grafts for bridging long nerve defects. Moreover, arterialized neurovenous flaps (ANVFs) have multiple potential advantages over traditional nerve flaps in this context. This paper describes a case of reconstruction of a long defect of the ulnar artery and nerve with an arterialized neurovenous free flap and presents a literature review on this subject. A 16-year-old boy sustained a stab wound injury to the medial aspect of the distal third of his right forearm. The patient was initially observed and treated at another institution where the patient was diagnosed with a flexor carpis ulnaris muscle and an ulnar artery section. The artery was ligated and the muscle was sutured. Four months later, the patient was referred to our institution with complaints of ulnar nerve damage, as well as hand pain and cold intolerance. Physical examination and ancillary tests supported the diagnosis of ulnar artery and nerve complete section. Surgery revealed an 8 cm hiatus of the ulnar artery and a 5 cm defect of the ulnar nerve. These gaps were bridged with a flow through ANVF containing the sural nerve and the lesser saphenous vein. The postoperative course was uneventful. Two years postoperatively, the patient had regained normal trophism and M5 strength in all previously paralyzed muscles according to the Medical Research Council Scale. Thermography revealed good perfusion in the right ulnar angiosome. The ANVF may be an expedite, safe and efficient option to reconstruct a long ulnar nerve and artery defect.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMicrosurgery. 2018 Feb;38(2):209-217.pt_PT
dc.identifier.doi10.1002/micr.30265pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3197
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAdolescentpt_PT
dc.subjectArm Injuriespt_PT
dc.subjectForearmpt_PT
dc.subjectFree Tissue Flapspt_PT
dc.subjectGraft Survivalpt_PT
dc.subjectHumanspt_PT
dc.subjectInjury Severity Scorept_PT
dc.subjectMalept_PT
dc.subjectNeurosurgical Procedurespt_PT
dc.subjectPrognosispt_PT
dc.subjectReconstructive Surgical Procedurespt_PT
dc.subjectRecovery of Functionpt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectSoft Tissue Injuriespt_PT
dc.subjectUlnar Arterypt_PT
dc.subjectUlnar Nervept_PT
dc.subjectCHLC CPRpt_PT
dc.titleReconstruction of a Long Defect of the Ulnar Artery and Nerve with an Arterialized Neurovenous Free Flap in a Teenager: A Case Report and Literature Reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage217pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage209pt_PT
oaire.citation.titleMicrosurgerypt_PT
oaire.citation.volume38pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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