For complete release from severe contracture of the first web space of the hand, suitable skin must be provided. The skin graft is occasionally not helpful because of contracture recurrence. The local flap is often insufficient and unable to fill the space after release. The distant flap is frequently bulky, requires a second operation for division and frequently demands further procedures for revisions.
A dorsalis pedis free flap precisely tailored allows unparalleled correction to be achieved with one surgical intervention. We have performed 6 cases of operation. It matched the dorsal skin ,of the hand in color, texture and thickness. Release, soft tissue reconstruction, bone graft and tendon graft can be completed in a single operative stage.
The average abduction distance which was measured between base of the middle finger and mid point of the interphalangeal joint of the thumb, was increased to 7cm after operation compared with 2.9cm before operation.
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