Reconstruction of Thumb Web Space Contracture of the Hand

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Journal of the Korean Society for Surgery of the Hand 2001;10(2):137-142.
Published online November 30, 2001.

Hyoung Min Kim, M.D., Suk Whan Song, M.D., Youn Soo Kim, M.D., Moon Gu Choi, M.D., Kee Haeng Lee, M.D., Chang Hoon Jeong, M.D., Jin Ho Jung, M.D.

내전 구축이 생긴 수부 무지 지간 공간의 재건술

김형민·송석환·김윤수·최문구·이기행·정창훈·정진호

Abstract

This study evaluated the results of reconstructions of thumb web space in the patients with adduction contracture of thumb. Between February 1990 and April 2000, 28 patients with thumb web space adduction contracture were treated with various reconstruction methods. We divided the patients according to the severity; mild(41°~8 0°), moderate(21°~4 0°), severe(20°l e s s ) contracture. The number of patients with mild contracture was 5, moderate; 12, severe; 11. We performed Z-plasty in 15, free flap in 8, local flap in 3, abdominal flap in 1 and scar release only in 1 case. The mean follow-up period was 5.7 years, ranged from 1.5 to 11.2 years. The results of web reconstruction were evaulated by thumb web space angle. There were excellent in 9, good in 16, fair in 3 cases. Z-plasty was performed in the 5 cases with mild contracture, and all the results were excellent. Especially, free flap was performed in the 6 cases with severe contracture, and all the results were good or excellent.
In the reconstruction of thumb web space contracture, we recommend Z-plasty for a mild contracture, and free flap for large soft tissue defect created by release of a severe contracture.

Key Words: Thumb web space, Adduction contracture, Free flap

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