First Palmar Intermetacarpal Flap for Congenital First Web Contracture: A Case Series

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2025-01-08 DOI:10.1002/micr.70022
Diego Gonzalez-Morgado, Vivian Sinclair, Xiao F. Shen, Javier Buendía-Pérez, Juliana Rojas-Neira, Francisco Soldado
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引用次数: 0

Abstract

Background

Pediatric first web space contractures of the hand can lead to disability in hand function. Several techniques have been proposed for treating this condition. Recently, a new technique involving the first palmar cutaneous flap was described in a cadaveric study. This report aimed to elucidate the clinical outcomes of the first palmar intermetacarpal flap in patients with congenital first web space contractures.

Patients and Methods

Case series of patients with moderate-to-severe first web contracture underwent surgery with the first palmar intermetacarpal flap. The variables included age, sex, diagnosis, preoperative and postoperative first intermetacarpal angle (IMCA), associated surgical procedures, postoperative complications, and follow-up time.

Results

Ten patients with a median age of 4 years and 8 months (range: 1 year and 5 months–16 years and 6 months) underwent surgery on a total of 12 hands. The median follow-up was 25 months (range: 12–49 months). IMCA increased in all patients following surgery, from a preoperative median of 20° (range: 0°–20°) to a postoperative median 40° (range: 30°–40°). Associated surgical procedures were performed in eight cases. Five simple complications occurred, including four cases of full-thickness skin graft pigmentation and one case of distal flap tip dehiscence.

Conclusions

The first palmar intermetacarpal flap is an effective option in the surgical management of moderate-to-severe first web contractures.

第一掌间皮瓣治疗先天性第一蹼挛缩一例。
背景:小儿第一次手部空间挛缩可导致手部功能障碍。已经提出了几种治疗这种疾病的技术。最近,一项涉及第一掌皮瓣的新技术在尸体研究中被描述。本报告旨在探讨第一掌间皮瓣治疗先天性第一蹼挛缩的临床效果。患者与方法:对中重度第一蹼挛缩患者行第一掌间皮瓣手术。变量包括年龄、性别、诊断、术前和术后第一掌间角(IMCA)、相关手术方式、术后并发症和随访时间。结果:10例患者中位年龄为4岁8个月(范围:1岁5个月-16岁6个月),共手术12只手。中位随访为25个月(范围:12-49个月)。手术后所有患者的IMCA均增加,从术前中位20°(范围:0°-20°)到术后中位40°(范围:30°-40°)。8例行相关手术治疗。单纯并发症5例,包括4例全层植皮色素沉着,1例远端皮瓣尖端开裂。结论:第一掌掌间皮瓣是治疗中重度第一指腹挛缩的有效方法。
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来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
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