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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

Case 1 post-op. the index and little fingers have been treated with z plasty supplemented with full-thickness skin grafts. The middle and ring fingers have had H-shaped incisions and fall back flaps, with a flag flap to the middle and a full thickness to the ring for the residual defects
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Figure 6: Case 1 post-op. the index and little fingers have been treated with z plasty supplemented with full-thickness skin grafts. The middle and ring fingers have had H-shaped incisions and fall back flaps, with a flag flap to the middle and a full thickness to the ring for the residual defects

Mentions: The index and little fingers were treated with z plasty, but in both cases additional skin was needed in the form of a full-thickness skin graft. After full release of the middle finger, the wound over the PIPJ was not ideal for a graft and, therefore, a flag flap was taken from the dorsum of the index and a full-thickness skin graft was applied to the secondary defect. In the ring finger, full release was possible with an ideal wound bed for a graft and, therefore, a full-thickness skin graft was sufficient for this digit [Figure 6].


Reconstruction of severe hand contractures: An illustrative series.

Tucker SC - Indian J Plast Surg (2011)

Case 1 post-op. the index and little fingers have been treated with z plasty supplemented with full-thickness skin grafts. The middle and ring fingers have had H-shaped incisions and fall back flaps, with a flag flap to the middle and a full thickness to the ring for the residual defects
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: Case 1 post-op. the index and little fingers have been treated with z plasty supplemented with full-thickness skin grafts. The middle and ring fingers have had H-shaped incisions and fall back flaps, with a flag flap to the middle and a full thickness to the ring for the residual defects
Mentions: The index and little fingers were treated with z plasty, but in both cases additional skin was needed in the form of a full-thickness skin graft. After full release of the middle finger, the wound over the PIPJ was not ideal for a graft and, therefore, a flag flap was taken from the dorsum of the index and a full-thickness skin graft was applied to the secondary defect. In the ring finger, full release was possible with an ideal wound bed for a graft and, therefore, a full-thickness skin graft was sufficient for this digit [Figure 6].

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