RECONSTRUCTION OF POSTBURN CONTRACTURE OF FIRST WEB SPACE OF THE HAND

Abstract

Background: Soft tissue reconstruction of the first web space remained a challenge for plastic and reconstructive surgeons. First web space adduction contractures are a common consequence of hand burns. Many reconstructive techniques are used and investigation for more effective methods continues.
Objective: assess the range of movement as regard opposition, palmar abduction and thumb extension. Also assessed the depth of web space after reconstruction of post burn contracted first web space to ass the method of covering the defect after release..
Materials and Methods: 35 patients’ ages ranged from 12 to 59 years (with mean 31.7), years; 23 males and 12 females admitted to our Hospital during the period from June 2008 to May 2012. All patients were suffering from post-burn first web contractures. The patients underwent a variety of surgical procedures. The follow-up period ranged from one to three years.
Results: Full range of motion achieved in most patients, but not those with joint affections.
Conclusions: In our experience, surgical correction of first web space contractures- in the form of flaps good results followed by skin grafts- results in meaningful functional enhancement. The outcomes depend primarily on the severity of contracture. Functionally limiting recontracture is rare in our experience and its best prevented by appropriate therapy
Keywords: Contracture; Burns; First web space reconstruction.