Simultaneous Opponensplasty and Free Gracilis Muscle Flap for Thenar Reconstruction after Arteriovenous Malformation Resection

Abstract

We report the case of a thenar eminence arteriovenous malformation presenting with continuous growth and pain that was treated with surgical excision after embolization. Extracapsular resection compromised thenar muscles which function was reconstructed with extensor indicis proprius transfer for opposition and abduction, and neurotized free gracilis muscle flap for opposition and adduction, as well as thenar eminence reconstruction.

Keywords

thenar reconstruction - arteriovenous malformation - opponensplasty - free gracilis muscle flap

Publication History

Article published online:
17 April 2020

• References

• 1 Ranieri M, Wohlgemuth W, Müller-Wille R. et al. Vascular malformations of upper and lower extremity - from radiological interventional therapy to surgical soft tissue reconstruction -an interdisciplinary treatment. Clin Hemorheol Microcirc 2017; 67 (3-4): 355-372
• 2 Baker PA, Watson SB. Functional gracilis flap in thenar reconstruction. J Plast Reconstr Aesthet Surg 2007; 60 (07) 828-834
• 3 Burkhalter W, Christensen RC, Brown P. Extensor indicis proprius opponensplasty. J Bone Joint Surg Am 1973; 55 (04) 725-732
• 4 Lemonas P, Laing T, Ghorbanian S, Malahias M, Ragoowansi R. Extensor indicis proprius opponensplasty - the Burkhalter revisited. J Hand Microsurg 2012; 4 (02) 47-49
• 5 Davis TRC, Barton NJ. Median nerve palsy. In: Green DP, Hotchkiss RN, Pederson C. eds. Green’s Operative Hand Surgery. 4th ed. Vol. 2. Philadelphia, PA: Churchill Livingstone; 1999: 1497-1525