Post-traumatic massive hand lymphedema fully cured by vascularized lymph node flap transfer
Corinne Becker1, Lionel Arrivé2, Giuseppe Mangiameli1, Ciprian Pricopi1, Fanomezantsoa Randrianambinina1, and Francoise Le Pimpec-Barthes1,3. SICOT-J 2018, 4, 53
Post-traumatic localized hand lymphedema is a rare situation and its diagnosis may be difficult, causing lack of care leading to failure of care. Our case study is of two young women with massive post-traumatic hand lymphedema who were treated for algodystrophy for 2 years, and whose bandages and physiotherapy were unsuccessful. Major social and psychological consequences were observed due to difficulty with diagnosis and management over several years. Noncontrast magnetic resonance lymphography revealed complete lymphatic vessel blockage in the hand and wrist. A vascularized lymph node flap harvested at the groin level was transferred to the elbow level 1 month after local dermolipectomy. These procedures resulted in the restoration of lymphatic flow. Both patients were definitely cured, and they returned to normal life within 6 months after surgery. Lymph node flap transfer associated with dermolipectomy may cure massive localized lymphedema in selected cases.