Vascularized free flaps for reconstruction after resection of congenital arteriovenous malformations of the hand.

Between 1981 and 1996, the authors performed reconstructions with vascularized free flaps in four patients with congenital arteriovenous malformations of the hand. This series included one man and three women, whose ages at the time of surgery ranged from 20 to 57 years, with an average of 41 years. All were categorized as fast-flow type B malformations. The locations of the arteriovenous malformations were the thumb only, thumb to palm, index to palm, and thumb and index to palm. In all cases, free vascularized flaps (two dorsalis pedis, one wrap-around, and one peroneal) were utilized to replace the resected abnormal skin lesions. Follow-up ranged from 1 year to 18 years and 9 months, with an average of 7 years. All flaps survived with no complications, and all patients were relieved of their preoperative symptoms. One patient unfortunately committed suicide for unknown reasons. The authors recommend that complete resection be carried out whenever possible. When skin is involved, repair should be carried out with a free flap. Based on the good results achieved in the case followed-up for over 18 years, vascularized free flaps proved very useful for the treatment of arteriovenous malformations.