Multiple Finger Reconstruction with Syndactylized Free Lateral Arm Flap

Objective: This study aimed to retrospectively evaluate the clinical and functional outcomes of multiple finger reconstructions using a syndactylized free lateral arm flap. Methods: Patients who underwent reconstruction with a syndactylized free lateral arm flap between 2013 and 2024 were retrospectively reviewed. Recorded variables included the localization of finger soft-tissue defects, associated injuries, flap dimensions, recipient vessels for anastomosis, vascular complications, and timing of flap separation. At final follow-up, finger joint range of motion was assessed using goniometry, and sensory recovery was evaluated using two-point discrimination (2PD) and Semmes–Weinstein monofilament (SWM) testing. Functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Results: Fifteen patients with extensive soft-tissue defects involving 37 fingers were included. The mean flap size was 5.2 Å~ 10.7 cm. One flap was lost due to venous insufficiency. Flap separation was performed between 20 and 92 days postoperatively (mean, 58 days). Twopoint discrimination exceeded 15 mm in all patients, including those who underwent nerve coaptation. All patients demonstrated varying degrees of protective sensation on SWM testing. Elbow joint range of motion at the donor site was preserved in all cases. The mean QuickDASH score was 31.2. Conclusion: The lateral arm flap provides thin, pliable tissue with reliable vascular anatomy, allows harvesting from the same extremity, and offers the possibility of osteocutaneous reconstruction. A syndactylized free lateral arm flap represents a viable option for the reconstruction of extensive soft-tissue defects involving multiple fingers. Careful patient selection and consideration of patient compliance are critical when deciding between complex reconstruction and amputation. Cite this article as: Erol K, Yener C, Er E, Güntürk ÖB. Multiple finger reconstruction with syndactylized free lateral arm flap. Acta Orthop Traumatol Turc., 2026; 60(2), 0668, doi: 10.5152/j.aott.2026.25668.