Muhammad Ahmad.
Management of digital flexion contractures.
Isra Med J Jan ;6(1):9-11.

OBJECTIVES: To present the experience of management of the digital flexion contractures. STUDY DESIGN: An intervenional study. PLACE AND DURATION: The study was conducted in a private setup from January 2006 to December 2008. METHODOLOGY: All the patients presenting with digital flexion contractures of hand were included and patients with fixed digital joint deformity and contractures of less than three months duration were excluded from the study. The contractures were released and skin graft/flap was harvested. In majority of the cases, the digits were kept straight with K-wire. The dressing was changed on 8th postoperative days and k-wire was removed after 3 weeks and active/passive movements were advised. In case of flaps, careful monitoring was ensured. A POP splint was advised for next 3 months along with the physiotherapy. Any complication encountered was also noted and managed accordingly. RESULTS: in a total of 56 patients, majority of the patients were males (64.3%). Mean age was 24.8 years in males and 19.8 years in females. More than half of the patients had postburn flexion contractures (55.4%) followed by post traumatic (37.5%) and post infective (7.1%). The duration of the deformity ranged from 3 months to 31 months (mean= 15.0 months). About 16% of the patients belonged to age group below 10 years. Majority of the patients had involvement of right hand (53.6%) and 66.1% of the patients had single digit involvement whereas 33.9% had two or more digits involvement. Different operative modalities were undertaken including Z-plasties, skin grafts and flap coverage. No flap loss was seen during the study. Five patients underwent flap surgery whereas the remaining 16 patients developed sensations in the skin grafted area. CONCLUSION: Early treatment of contractures with skin graft or flap results in the improvement of finger mobility.

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