title: Correction of long standing proximal interphalangeal flexion contractures with cross finger flaps and vigorous postoperative exercises.
abstract: OBJECTIVE
  We reviewed the results of cross finger flaps after surgical release and vigorous postoperative exercises for long-standing, severe flexion contractures of the Proximal Interphalangeal (PIP) joints of fingers.
  
  
  METHODS
  In 9 patients, all contracted tissue was sequentially released and the resultant skin defect was covered with a cross-finger flap. The cause of the contracture was contact burn in 4, skin graft in 3, and a previous operation in 2. The mean followup period was 41.2 months.
  
  
  RESULTS
  The mean flexion contracture/further flexion in the joints were improved from 73.4/87.8 degrees to 8.4/95.4 degrees at the last follow-up. A mean of 19.5 degrees of extension was achieved with vigorous extension exercise after the operation. The mean gain in range of motion (ROM) was 79.4 degrees. Near full ROM was achieved in 3 cases. There were no major complications.
  
  
  CONCLUSIONS
  In severe flexion contractures with scarring of the PIP joints of fingers, cross finger flaps after sufficient release and vigorous postoperative exercise seems to be a reasonable option to obtain satisfactory ROM of the joints.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Hahn
authors.forename: Ho Jung
authors.initials: HJ
authors.lastname: Kang
authors.forename: Eung Shick
authors.initials: ES
authors.lastname: Kang
authors.forename: Yun Rak
authors.initials: YR
authors.lastname: Choi
mesh_terms: D000328:Adult; D003286:Contracture / Q000534:rehabilitation / Q000601:surgery*; D005081:Exercise Therapy; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013524:Surgical Flaps