<bold>The aim of the study</bold> was to evaluate the efficacy of pedicled osteocutaneous groin flaps in treatment of tissue defects of the hand.
<bold>Material and methods.</bold> Twelve pedicled osteocutaneous groin flaps were used to fill bone defects of the hand in the same amount of patients (10 males and 2 females) aged 20-53 years (mean 33.4 years, SD 12 years). The defects affected metacarpal bones and wrist in 2 cases, metacarpus alone in 3 cases, fingers - in 4 (total amputations of 3 or 4 fingers), and thumb in 3 (total amputations). The osseous fragment measured from 6-18 ccm (mean 12.4 ccm). The osteosynthesis was performed using K-wires (10 patients) or AO headless cortical screw (2 patients). The flaps were detached gradually starting from postoperative day 18 with the final detachment performed on p.o. day 24-33 (mean 27.2 days, SD 6 days). Once after flap detachment the patients maintained the limb immobilized in a plaster cast for 5 weeks.
Beside local abscess which was successfully treated with compresses, healing of the surgical site was uncomplicated. The bony union was assessed radiological and occurred after 9-13 weeks (mean 11.1 weeks, SD 5 weeks). Due to delayed bone union, one patient required bone slivers grafting which finally lead to unification. All the patients needed secondary plastic surgery of subcutaneous tissue of the flap; however, only 9 of them consented to it. In three patients we substituted the sensibility with a nerve graft according to Holevich.
<bold>Results.</bold> The described operation did not improve function in patients with wrist-level and metacarpal osseous defects but improved its esthetical aspect; in the other patients the hand function was significantly restored.
<bold>Conclusions.</bold> In patients disqualified for other methods of reconstructions of the thumb, fingers and bone defects of the hand a satisfactory result may be achieved by using pedicled osteocutaneous flaps from the iliac crest. This method proved to be highly effective.
