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Arch Hand Microsurg > Volume 24(3); 2019 > Article
Archives of Hand and Microsurgery 2019;24(3):260-266.
Published online September 1, 2019.
DOI: https://doi.org/10.12790/ahm.2019.24.3.260   
Sensate Medial Plantar Free Flap Transfer and Adductor Pollicis Myotomy for Treatment of Palmar Burn Scar Contracture
Inhoe Ku, Euicheol Jeong
Department of Plastic Surgery, Seoul National University College of Medicine, Seoul, Korea. ecjeong@snu.ac.kr
Received: 28 February 2019   • Revised: 25 April 2019   • Accepted: 3 June 2019
Abstract
A postburn contracture involving the palmar skin and subcutaneous tissues results in a severe loss of functionality of the affected hand. The corrective surgical procedures aim for an improvement of the range of motion of the metacarpophalangeal (MCP) joints and target the reconstruction of a durable and sensitive palmar-specific anatomical structure. We successfully treated a 53-year-old male patient with a long-standing postburn contracture of all the right MCP joints and underlying palmar tissue. We performed contracture release and adductor pollicis myotomy and reconstructed the resultant palmar defect with a sensate medial plantar free flap to restore acute skin sensitivity and resurface the glabrous skin of the palm. The Kirschner-wire fixation utilized for stabilizing the extended MCP joints was maintained for 3 weeks after contracture release. The restored palmar skin and soft tissue improved the MCP joint movements, enabling grasping and pinching motions and thus restoring functionality of the operated hand.
Key Words: Surgical flaps, Hand, Burns, Contracture
 


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