Reconstruction of severe hand contractures: An illustrative series

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.

Evaluation of Functional Outcomes After Reconstruction of Post-burn Contracture of the Hand in the Pediatric Age Group: A Prospective Study

“…When a hand is severely involved, the choice of the first set of procedures is very important, as it contributes the most to improving the functional outcome of the surgery for the patient [15]. Excision of the scar tissue and correction of the deforming forces, followed by soft tissue reconstruction, are needed for the amelioration of the deformity [16]. Good preoperative planning for reconstruction and opting for the most simple method is needed to achieve the reconstructive goals [17].…”

Double Stiletto Flap for Soft Tissue Cover as a Firebreak Following Contracture Release of Digits and Full-Thickness Grafting: A Surgical Technique

“…Stern et al noted a 20% recurrence following contracture release and grafting of postburn proximal interphalangeal (PIP) joint flexion contractures. 1,2 Various local techniques described earlier include cross-finger flap, dorsolateral flap, digitolateral flap, bilateral side finger transposition flap, combined side finger transposition flap with cross-finger flap, combined double side finger transposition flap with skin graft, and Z plasty. [3][4][5][6][7][8][9] We report a technique (►Fig.…”