Free tissue transfers for upper extremity reconstruction.

This study is a functional analysis of 18 free tissue transfers with a 1-to 4-year follow-up including: Six free skin flaps, two neurovascular free flaps, four free fibula, one free muscle, and three toe-to-thumb transfers. All tranfers survived except for one partial slough. Free skin-flaps allow single-stage skin coverage, a permanent blood supply, earlier secondary surgery, and potential sensory reinnervation. Free fibula transfer for long bone defects offer more rapid healing and incorporation in unfavorable recipient beds than do conventional grafts. Toe-to-thumb transfers have proven extremely valuable for thumb reconstruction, especially following multiple digit loss.