[Repair of flexor contracture of the hand].

OBJECTIVE

To investigate the etiology of the flexor contracture of the hand, to diagnose and to explore its surgical treatment.

METHODS

From May 1997 to June 2004, 212 cases of flexor contraction of the hand were treated with scar excision, thorough loosening the contracture, covering the secondary skin defects with free skin grafting, "Z"-plasty, double "V-Y" plasty, transposition of the palmar dorsum flap of the hand and iliac-inguinal flap. There were 163 males and 49 females, whose ages ranged from 3 to 61. There were 85 cases of left hands, 54 cases of right hands, and 73 cases of both hands. Contracture sites were as follow: 117 cases were in fingers, 32 cases located in palms and 63 cases were in both. Causes of deformity were as follow: 29 cases derived from burn and explosion, 127 cases came from contracture of palmar aponeurosis, 31 cases were because of traffic accident and machine extrusion, 5 cases for getting an electric shock, 14 cases for improper postoperative immobility, and 6 cases for other reasons. Course of diseases lasted for 2 to 24 months.

RESULTS

149 cases were followed up for 4 to 30 months. One fingertip was in necrosis and ended in nub plasty because of inappropriate time to leave hospital. Flexion contracture recurred in 7 cases, skin necrosis occurred to 3 cases whose scars were healed in the end, poor restoration of function was observed in 2 children patients for lack of exercise, and 2 skins contracted after free cut skin grafting. Others got satisfactory results.

CONCLUSION

Once the pathogenesis and contracture factors are clearly known, timing and correct surgical measures are chosen, thorough contracture is loosened, and early postoperative exercises are performed, good effect will be achieved.