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Reconstruction of severe hand contractures: An illustrative series.

Tucker SC - Indian J Plast Surg (2011)

Bottom Line: The decision making process is presented as a flow chart indicating when and which flaps were used.Illustrations demonstrate what was achieved, with all hands obtaining an improvement in function.Although many of these contractures can be dealt with by skin grafting the series clearly illustrates the indications for flap coverage.

View Article: PubMed Central - PubMed

Affiliation: Green Pastures Leprosy and Rehabilitation Hospital, Pokhara, Nepal.

ABSTRACT

Aim: An overview of a series of severe burn contractures in 44 hands reconstructed over a 20 month period with an easy to follow algorithm.

Settings and design: The series was carried out by a single surgeon at Green Pastures Rehabilitation Centre in Pokhara, Nepal. All patients attending with severe burn contractures to the hand were included in the series.

Materials and methods: This is a retrospective review of burn contractures in a total of 44 hands. All the contractures involved limitation of movement by 60 degrees in two or more joints or by 80 degrees in one joint. The decision making process is presented as a flow chart indicating when and which flaps were used.

Results: Illustrations demonstrate what was achieved, with all hands obtaining an improvement in function.

Conclusions: Although many of these contractures can be dealt with by skin grafting the series clearly illustrates the indications for flap coverage.

No MeSH data available.


Related in: MedlinePlus

Algorithm to illustrate the decision-making process for palmar contractures
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Related In: Results  -  Collection

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Figure 2: Algorithm to illustrate the decision-making process for palmar contractures

Mentions: Figures 2 and 3 show the reconstructive surgical decision-making algorithms drawn up towards the end of the time when there was an opportunity to reflect on the cases carried out and analyse the factors that had led to the options chosen. At the time that the majority of the clinical decisions were made, they were carried out on a case by case basis. But, on a retrospective review of the series, it became quite clear that there were consistent boundaries that triggered a decision to opt for a more complex reconstruction. These have been drawn up into a decision making tree to illustrate the process that was used in this series and to facilitate comparison with other practitioners.


Reconstruction of severe hand contractures: An illustrative series.

Tucker SC - Indian J Plast Surg (2011)

Algorithm to illustrate the decision-making process for palmar contractures
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111127&req=5

Figure 2: Algorithm to illustrate the decision-making process for palmar contractures
Mentions: Figures 2 and 3 show the reconstructive surgical decision-making algorithms drawn up towards the end of the time when there was an opportunity to reflect on the cases carried out and analyse the factors that had led to the options chosen. At the time that the majority of the clinical decisions were made, they were carried out on a case by case basis. But, on a retrospective review of the series, it became quite clear that there were consistent boundaries that triggered a decision to opt for a more complex reconstruction. These have been drawn up into a decision making tree to illustrate the process that was used in this series and to facilitate comparison with other practitioners.

Bottom Line: The decision making process is presented as a flow chart indicating when and which flaps were used.Illustrations demonstrate what was achieved, with all hands obtaining an improvement in function.Although many of these contractures can be dealt with by skin grafting the series clearly illustrates the indications for flap coverage.

View Article: PubMed Central - PubMed

Affiliation: Green Pastures Leprosy and Rehabilitation Hospital, Pokhara, Nepal.

ABSTRACT

Aim: An overview of a series of severe burn contractures in 44 hands reconstructed over a 20 month period with an easy to follow algorithm.

Settings and design: The series was carried out by a single surgeon at Green Pastures Rehabilitation Centre in Pokhara, Nepal. All patients attending with severe burn contractures to the hand were included in the series.

Materials and methods: This is a retrospective review of burn contractures in a total of 44 hands. All the contractures involved limitation of movement by 60 degrees in two or more joints or by 80 degrees in one joint. The decision making process is presented as a flow chart indicating when and which flaps were used.

Results: Illustrations demonstrate what was achieved, with all hands obtaining an improvement in function.

Conclusions: Although many of these contractures can be dealt with by skin grafting the series clearly illustrates the indications for flap coverage.

No MeSH data available.


Related in: MedlinePlus