Ulkür Ersin, Uygur Fatih, Karagöz Huseyin, Celiköz Bahattin
Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic and Reconstructive Surgery, Istanbul, Turkey.
Ann Plast Surg. 2007 May;58(5):479-83. doi: 10.1097/01.sap.0000244973.72940.e3.
Many regions of the hand are affected seriously in the patients with complex severe postburn hand contractures. Multiple flap choices should be in count to treat complex severe postburn hand contractures affectively. We preferred dorsal ulnar flap for palmar region, cross-finger flap, side finger flap, and combined use of both for flexion contracture of the fingers, and rhomboid flap for web contractures. Eight patients having complex severe postburn hand contractures were treated between November 2001 and February 2005. The maximum improvements of the joint extensions were 75 degrees for median of digits metacarpophalangeal joint and 105 degrees for proximal interphalangeal joint. Grasp function of the hand dramatically improved, and the bulk of the flap did not interfere grasping. Complex severe postburn hand contracture can be treated sufficiently with dorsal ulnar flap, combined use of cross-finger and side finger transposition flap, and rhomboid flap.
复杂严重烧伤后手部挛缩患者手部的许多区域受到严重影响。应考虑多种皮瓣选择以有效治疗复杂严重烧伤后手部挛缩。对于手掌区域，我们首选尺背皮瓣；对于手指屈曲挛缩，选用交指皮瓣、侧方手指皮瓣或两者联合使用；对于蹼挛缩，选用菱形皮瓣。2001年11月至2005年2月期间，对8例复杂严重烧伤后手部挛缩患者进行了治疗。掌指关节中位数的关节伸展最大改善为75度，近端指间关节为105度。手部抓握功能显著改善，皮瓣体积未干扰抓握。采用尺背皮瓣、交指和侧方手指移位皮瓣联合使用以及菱形皮瓣可充分治疗复杂严重烧伤后手部挛缩。
