Comparison of two methods in the treatment of finger flexion deformity of scar contracture

W. Feng, Danmou Xing, D. Ren, Yan Chen, Huan Wang, Zhiming Zhao, Zhihong Xiao, Ming Zhang
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Abstract

Objective To investigate the clinical efficacy, indications and precautions of dual intersecting trapezoid flaps and laterodigital flaps in the treatment of finger flexion deformity of scar contracture. Methods From February 2014 to October 2016, 14 patients (25 fingers) with finger flexion deformity of scar contracture were treated. According to the extension of scar contracture line, dual intersecting trapezoid flaps were used in 7 cases (12 fingers) (group A) and laterodigital flaps were used in 7 cases (13 fingers) (group B). The repair range, infection and necrosis rate, total active motion of inured finger (TAM), extension rate of scar contracture line and reoperation were compared between the two groups. Results All the flaps survived uneventfully. The repair range of group A reached the level of DIP and group B reached the level of PIP. There was no reoperation due to recurrence of scar contracture in both groups, but the satisfaction of group B was lower than that of group A. Conclusion The dual intersecting trapezoid flaps have reliable blood supply and the operation is simple, the repair range of which can reach the level of DIP. They can allow early joint movement. It is a more ideal method for the treatment of finger flexion deformity of trans-articular scar contracture. Key words: Surgical flaps; Finger injuries; Cicatrix; Contracture
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两种方法治疗瘢痕挛缩型手指屈曲畸形的比较
目的探讨双相交梯形瓣与侧指瓣治疗瘢痕挛缩型手指屈曲畸形的临床疗效、适应证及注意事项。方法对2014年2月~ 2016年10月收治的瘢痕挛缩型手指屈曲畸形患者14例(25指)进行治疗。根据瘢痕挛缩线的延伸,采用双相交梯形皮瓣7例(12指)(A组),侧指皮瓣7例(13指)(B组)。比较两组间的修复范围、感染坏死率、损伤手指总活动度(TAM)、瘢痕挛缩线延伸率及再手术情况。结果皮瓣全部成活。A组修复范围达到DIP水平,B组修复范围达到PIP水平。两组均无因瘢痕挛缩复发而再次手术,但B组满意度低于a组。结论双相交梯形皮瓣血供可靠,操作简便,修复范围可达DIP水平。它们可以让关节早期活动。是一种较为理想的治疗手指屈曲畸形的经关节瘢痕挛缩的方法。关键词:外科皮瓣;手指受伤;叶痕;挛缩
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