The post-burn elbow medial flexion scar contracture treatment with trapeze-flap plasty.
A medial flexion elbow contracture is characterized by the presence of a fold which has a semi-lunar shape, the sheets of which are scars. The shortage in skin length and the excess in width occurs in the sheets. To estimate the size and form of length deficiency in the fold is the section from the top of the fold to the rotation axis of the joint. As a rule, the wound receives a trapeze form. To convert the sheets of the fold into trapeze-shaped flaps, several radial cross-sections from the tops of the fold to joint rotation axis are used. The flaps are mobilized with the full fat layer, and then transposed toward one another causing tension, therefore, covering the wound on the flexion surface of the joint. Flaps and the adjacent skin, displaced forward from lateral and back surfaces of the joint, participate in wound coverage. Trapezoid flaps have a wide end, stable blood circulation; they do not undergo rotation, therefore, do not undergo necrosis. Contractures are eliminated in full without relapse. As a rule, in all 35 patients the functional outcome was perfect.
Department of Reconstructive and Plastic Surgery, A.V. Vishnevsky Institute of Surgery of the Russian Academy of Medical Sciences, Moscow, Russia. grishkevichmail@gmail.com
Viktor M
VM
Grishkevich
D002056:Burns / Q000150:complications*; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D004550:Elbow / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology; D000092464:Elbow Injuries