Foucher G, Fehki S, Erhard L
SOS Main, Chirurgie de la Main, des Nerfs, Microchirurgie, Clinique du Parc, Strasbourg, France.
Ann Chir Plast Esthet. 1998 Feb;43(1):51-7.
Skin retraction is a commonly observed complication of severe joint stiffness in the hand. After freeing the joint, this raises the problem of closing the skin without tension to avoid necrosis, disunion or pain during early rehabilitation and splinting. We have used a simple rotation flap for PIP extension (and hyperextension) stiffness and a "castle" flap for PIP flexion retraction and for both extension and flexion stiffness of the MPJ. It consists in withdrawing the skin (dorsal or palmar) of the phalanx distal to the freed joint. We have used this flap in 13 clinical cases of severe stiffness and it allowed wide access to all structures involved and facilitated early post-operative mobilization.
皮肤回缩是手部严重关节僵硬常见的并发症。在松解关节后，会出现无张力闭合皮肤的问题，以避免早期康复和夹板固定期间出现坏死、不愈合或疼痛。我们针对近端指间关节（PIP）伸直（和过伸）僵硬采用了一种简单的旋转皮瓣，针对PIP屈曲回缩以及掌指关节（MPJ）伸直和屈曲僵硬采用了“城堡”皮瓣。它包括在松解关节远侧的指骨处提起皮肤（背侧或掌侧）。我们已将此皮瓣应用于13例严重僵硬的临床病例，它能广泛显露所有受累结构，并便于术后早期活动。
