Yonsei Med J.  2010 Jul;51(4):574-578. 10.3349/ymj.2010.51.4.574.

Correction of Long Standing Proximal Interphalangeal Flexion Contractures with Cross Finger Flaps and Vigorous Postoperative Exercises

• Hahn SB
• Kang HJ
• Kang ES
• Choi YR

• KMID: 1805197
• DOI: http://doi.org/10.3349/ymj.2010.51.4.574

Abstract

PURPOSE
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.
MATERIALS AND 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 follow-up period was 41.2 months.
RESULTS
The mean flexion contracture/further flexion in the joints were improved from 73.4/87.8degrees to 8.4/95.4degrees at the last follow-up. A mean of 19.5degrees of extension was achieved with vigorous extension exercise after the operation. The mean gain in range of motion (ROM) was 79.4degrees. 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.

Keyword

Flexion contracture; finger; surgical release; cross finger flap; vigorous extension exercise

Figure

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  Fig. 1 (A) A 51-year-old woman presented with a chronic, 90° fixed flexion contracture of the proximal interphalangeal joint of right fourth finger caused by a burn injury 50 years ago. (B) All contracted tissue was released sequentially and the resultant skin defect was covered with stable and redundant skin by a using cross-finger flap from the neighboring third finger. (C and D) A at 30-month follow-up, near full range of motion (extension 0° and flexion 105°) was achieved without extension lag.

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  Fig. 2 Vigorous extension exercise started just after removal of the intraarticular Kirschner wire at 2 weeks postoperatively.

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