We retrospectively assessed outcomes after treating severe contractures of the first web space from burns with the reverse posterior interosseous flaps (RPIF). Twelve consecutive patients (ages 18-58 years) with burns from 10% to 70% (mean, 30.1%) total body surface. area and severe contractures of the first web space of the hand (initial thumb to index angles from 10 to 35 degrees [mean, 23 degrees]) underwent contracture release using the RPIF. Seventeen RPIFs were used, with sizes from 9 cm x 6 cm to 14cm x 10 cm (mean area, 83.6 cm(2)). The patients were followed for 5-26 months. All flaps survived completely, rapidly adapted to the recipient beds, and achieved good color and texture harmony. No early complications occurred. Fifteen donor sites were closed with skin grafts. Two donor sites were closed by direct suture. No paralysis of the posterior interosseous nerve was observed in these cases. At last follow-up the mean thumb to index angle was 78 degrees, increasing the web length 260%. All patients regained fundamental hand functions. The RPIF is reliable and safe for releasing severe contractures of the first web space of the hand after burn, with distinct advantages over currently used alternative methods. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.
[1]Ji Lin Univ, Hosp 1, Dept Burns & Plast Surg, Changchun 130021, Peoples R China.
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