Release of the first web space with the "goalpost" procedure in pediatric burns.
First web-space contractures commonly occur in dorsal and palmar hand burns. Both abduction and extension limitations develop as a result of reduction in thumb motion. Optimal treatment of first web-space contractures should treat both abduction and extension deformities and should minimize the need for reoperation in growing children. Many techniques exist to manage web-space contractures. This article describes a long rectangular flap release ("goalpost" procedure) used to treat first web deformities in pediatric patients with burns. During the period 1987 through 1989, 31 first web-space releases were performed in 23 patients (mean age 9.2 years). The operations were performed a mean of 50 months after burn injury. No wound complications occurred and no patient required repeat operation in the follow-up period. Range of motion in abduction and extension was increased a mean of 10 degrees. The goalpost procedure is a highly acceptable alternative to standard web-space releases and offers advantages in its ability to treat both abduction and extension contractures.
Housinger
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TA
Department of Surgery, University of Cincinnati College of Medicine, Shriners Burns Institute, OH 45229.
Ivers
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B
Warden
G D
GD
D000293:Adolescent; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000601:surgery*; D006225:Hand / Q000601:surgery*; D006230:Hand Injuries / Q000150:complications*; D006801:Humans; D007223:Infant; D013524:Surgical Flaps / Q000379:methods*