Pedicled Groin Flap: Reconstruction Strategies for Volkmann Ischemic Contracture

This book chapter presents a case report and discussion on the use of the pedicled groin flap for reconstructive surgery in a patient with post-electric burn Volkmann's ischemic contracture (VIC) and scarring at the wrist of the right hand. The case presentation describes the preoperative condition of inability to flex the fingers and thumb, clawed digits, and flattened eminences. The surgical intervention involved excision of the scar, carpal tunnel release, tenolysis, median and ulnar nerve epineuotomy, and reconstruction of the soft tissue defect using a pedicled groin flap.

The operative procedure included scar excision, carpal tunnel release, tenolysis, and neurolysis, followed by the creation of a pedicled groin flap for reconstruction. The flap was inset to cover the soft tissue defect at the wrist, and the donor site in the groin region was closed primarily. The postoperative period remained uneventful, and satisfactory results were observed during follow-up examinations.

The discussion section introduces the pedicled groin flap technique as a valuable reconstructive option for soft tissue defects in various anatomical regions. The surgical technique is described, including patient evaluation and planning, flap design and marking, incision and flap elevation, and flap transposition and closure. The advantages of the technique, such as robust blood supply, adequate tissue volume, versatility, and minimized donor site morbidity, are highlighted. The limitations, including vascular anatomy considerations, flap reach and tension, and potential complications, are also discussed.

The abstract emphasizes the significance of the pedicled groin flap technique in reconstructive surgery, particularly in cases of soft tissue defects. It highlights the importance of careful patient selection, precise surgical technique, and postoperative monitoring to achieve optimal outcomes and minimize complications. By understanding the principles and considerations of the pedicled groin flap technique, surgeons can effectively address complex defects and provide functional and aesthetically pleasing reconstructions for their patients.