Use of Homodigital Dosolateral Flaps for Management of Post-Burn PIPJ Flexion Contractures

Abstract

Hand burn injuries are commonly seen and need timely and careful management. If neglected, hand burns may lead to contractures. Moreover, old burn injuries of hand are difficult to manage with non-compliance with physiotherapy further compounding the problem. Management of post-burn contractures of the digits needs release followed by wound coverage. The dorsolateral flap is a local flap option for wound coverage that decreases the risk of re-contracture.

This prospective case series was conducted from January 2021 to December 2022, with a follow-up period of at least 6 months. A dorsolateral flap was performed for Type III PIPJ flexion contractures. The flap was used for wound coverage following contracture release. The secondary raw area was resurfaced with skin graft.

Fifteen patients were included in the study. Flap survival was 100%. In two cases, partial graft loss was seen and was managed conservatively. A second surgery was required in three cases for contracture at the inset site. No patients had contracture recurrence after at least 6 months of follow-up.

Dorsolateral flap is an easy and reliable local flap option for difficult post burn PIPJ contractures. It is easy to learn and replicate and does not need microsurgery.