Correction of long standing proximal interphalangeal flexion contractures with cross finger flaps and vigorous postoperative exercises.
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.
Hahn
Soo Bong
SB
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
Kang
Ho Jung
HJ
Kang
Eung Shick
ES
Choi
Yun Rak
YR
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