title: Release of severe post-burn contracture of the first web space using the reverse posterior interosseous flap: Our experience with 12 cases.
abstract: We retrospectively assessed outcomes after treating severe contractures of the first web space from burns with the reverse posterior interosseous flaps (RPIF). Twelve consecutive patients (ages 18-58 years) with burns from 10% to 70% (mean, 30.1%) total body surface area and severe contractures of the first web space of the hand (initial thumb to index angles from 10° to 35° [mean, 23°]) underwent contracture release using the RPIF. Seventeen RPIFs were used, with sizes from 9cm×6cm to 14cm×10cm (mean area, 83.6cm(2)). The patients were followed for 5-26 months. All flaps survived completely, rapidly adapted to the recipient beds, and achieved good color and texture harmony. No early complications occurred. Fifteen donor sites were closed with skin grafts. Two donor sites were closed by direct suture. No paralysis of the posterior interosseous nerve was observed in these cases. At last follow-up the mean thumb to index angle was 78°, increasing the web length 260%. All patients regained fundamental hand functions. The RPIF is reliable and safe for releasing severe contractures of the first web space of the hand after burn, with distinct advantages over currently used alternative methods.
authors.affiliation: Department of Burns and Plastic Surgery, The First Hospital of Ji Lin University, Chang Chun 130021, PR China.
authors.forename: Shi
authors.initials: S
authors.lastname: Kai
authors.forename: Jingchun
authors.initials: J
authors.lastname: Zhao
authors.forename: Zhenghua
authors.initials: Z
authors.lastname: Jin
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wu
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Chunhui
authors.initials: C
authors.lastname: Xie
authors.forename: Jiaao
authors.initials: J
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications* / Q000601:surgery; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D006230:Hand Injuries / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Contracture; First web space; Release; Reverse posterior interosseous artery flap