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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 3 post-op. dorsal view
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Figure 11: Case 3 post-op. dorsal view

Mentions: She underwent excision of the scar tissue, following which manipulation of the MCPJs was found to be sufficient to obtain 0–90 degrees of flexion [Figure 10]. There were areas of tendon exposure without paratenon and soft tissue cover was therefore carried out with a reverse radial forearm flap [Figures 11 and 12]. She commenced physiotherapy 5 days after the operation. Her resting position showed restoration of the normal cascade of finger flexion, except that the little finger had an extensor lag of 10–20 degrees, which persisted on active flexion for fist formation. She was able to form a fist and all digits participated in hand function. Even at this early stage, she was extremely pleased with the improved appearance and functioning of this hand.


Reconstruction of severe hand contractures: An illustrative series.

Tucker SC - Indian J Plast Surg (2011)

Case 3 post-op. dorsal view
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 11: Case 3 post-op. dorsal view
Mentions: She underwent excision of the scar tissue, following which manipulation of the MCPJs was found to be sufficient to obtain 0–90 degrees of flexion [Figure 10]. There were areas of tendon exposure without paratenon and soft tissue cover was therefore carried out with a reverse radial forearm flap [Figures 11 and 12]. She commenced physiotherapy 5 days after the operation. Her resting position showed restoration of the normal cascade of finger flexion, except that the little finger had an extensor lag of 10–20 degrees, which persisted on active flexion for fist formation. She was able to form a fist and all digits participated in hand function. Even at this early stage, she was extremely pleased with the improved appearance and functioning of this hand.

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