[Effectiveness of dorsal metacarpal island flap for treating scar contracture of finger web].
OBJECTIVE
To investigate the effectiveness of dorsal metacarpal island flap for treating scar contracture of the finger web.


METHODS
Between June 2009 and December 2010, 10 patients with scar contracture of the finger web were treated. There were 6 males and 4 females with an average age of 30 years (range, 14-57 years). Scar contracture was caused by injury in 8 cases, by burn in 1 case, and by operation in 1 case. The locations were the 1st web space in 1 case, the 2nd web space in 3 cases, the 3rd web space in 5 cases, and the 4th web space in 1 case. The disease duration was 3 to 9 months with an average of 5 months. The maximum abduction was 10-20 degrees. After web space scar release, the dorsal metacarpal island flap (3.5 cm x 1.2 cm-4.0 cm x 2.0 cm in size) was used to reconstruct web space (2.0 cm x 1.0 cm-3.0 cm x 1.8 cm in size). The donor site was directly sutured or repaired with local flaps.


RESULTS
At 2 days after operation, necrosis occurred in 1 flap, which healed by extractive treatment. The other flaps survived and wound healed by first intention; all the flaps at donor sites survived and incision healed by first intention. Ten patients were followed up 6 to 15 months (mean, 9 months). The reconstructed web space had good appearance, the maximum abduction was 80 degrees in 1 case of the 1st web space scars contracture, and the maximum abduction was 35-45 degrees (mean, 40 degrees) in the other 9 cases. In 8 scar patients causing by injury, no scar contracture recurred during follow-up.


CONCLUSIONS
It can achieve good results in appearance and function to use dorsal metacarpal island flap for treating scar contracture of the finger web.
Department of Hand Surgery, Hand Surgery Hospital of Wuxi, Wuxi Jiangsu 214061, PR China. qianshi0502@yahoo.com.cn
Jun
J
Qian
Yongjun
Y
Rui
Quanrong
Q
Zhang
Mingyu
M
Xue
Zhihai
Z
Zhang
D000293:Adolescent; D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008663:Metacarpus; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult