Comparison between Groin Flap and Distally Based Radial Forearm Flap in Resurfacing of Acute Soft Tissue Injury on the Palmar Surface of Hand

Abstract

Background: Hand injury is a common burden in orthopaedic & plastic surgery department. Resurfacing of such injury is commonly done by pedicled groin flap or distally based radial forearm flap. Objective: In this study our main goal is to evaluate the comparison between Groin Flap and Distally Based Radial Forearm Flap in Resurfacing of Acute Soft Tissue Injury on the Palmar Surface of Hand. Method: This is a comparative  observational study, conducted at Department of Orthopaedic Surgery and Burn and Plastic surgery Sylhet MAG Osmani Medical College Hospital from January 2018 to October 2019. A total of 16 patients with acute hand injury or pathology in the palm of hand which may create surgical wound, admitted in the study place during the study period were the study population. Where those who had acute wound in palm of hand with exposed tendon, nerve and bones or Degloving hand injury were included in the study. Patient were divided into two group namely Group-A and Group-B. Patient chosen for groin flap were allocated in group-A and for distally based radial forearm flap were in group-B. Results: During the study, the age of the patients ranged from 16 to 55 years with the mean age was 37.25 (SD±14) years in group A, while it was 20 to 55 years and 37 (SD±12) years in group B and 87% were male. mean duration of operation was 113.25 (SD±11) minutes in group A and 95.63 (SD±16) minutes in group B. in addition, It was observed that in almost two third 5(62.5%) of the patients post-operative hospital stay was 25 days in group A and 7 days in group B. The mean (±SD) hospital stay was 26.88
(±2.6) days in group A and 8.13 (±1.6) days in group B. A Single number of patients of group-A experienced donor site pain, haematoma and marginal necrosis, while none of group B developed such complications. A single patient of group A experienced shoulder joint stiffness in follow-up assessment at 6th & 9th week, which disappeared at final followup; while none of group B patient complaints of joint stiffness in follow-up period. Conclusion: This study reveals that mean operative time and mean hospital stay was shorter in radial forearm flap compared to groin flap and the difference was statistically significant (p<0.05).It is concluded that radial forearm flap has better outcome than groin flap.