A COMPARISON OF IMMEDIATE AND STAGED RECONSTRUCTION OF THE DORSUM OF THE HAND

The treatment of complex dorsal hand lesions involving skin and subcut aneous tissues, extensor tendons, and bone remains a difficult problem for reconstructive surgeons. Traditional treatment of these defects u ses staged reconstruction, first obtaining soft tissue cover and then performing bone and tendon grafts, The purpose of this study was to co mpare a series of seven patients who underwent staged reconstruction w ith seven patients who had immediate reconstruction involving primary bone and tendon grafting. All procedures were performed to correct sim ilar severe dorsal hand defects, Patients with immediate reconstructio n had a significantly faster return to maximum range of movement (ROM) (214 days compared to 630 days, P=0.002), significantly fewer operati ons (2.1 compared to 5.9, P=0.002) and a greater chance of returning t o work (86% compared to 48.2%, P=0.3) than patients with staged recons truction.