Arch Hand Microsurg 2019; 24(3): 260-266  
Sensate Medial Plantar Free Flap Transfer and Adductor Pollicis Myotomy for Treatment of Palmar Burn Scar Contracture
Inhoe Ku, Euicheol Jeong
Department of Plastic Surgery, Seoul National University College of Medicine, Seoul, Korea
Correspondence to: Euicheol Jeong
Department of Plastic Surgery, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea
TEL: +82-2-870-2331, FAX: +82-2-831-2826, E-mail: ecjeong@snu.ac.kr, ORCID: https://orcid.org/0000-0003-2434-875X
Received: February 28, 2019; Revised: April 25, 2019; Accepted: June 3, 2019; Published online: September 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
A postburn contracture involving the palmar skin and subcutaneous tissues results in a severe loss of functionality of the affected hand. The corrective surgical procedures aim for an improvement of the range of motion of the metacarpophalangeal (MCP) joints and target the reconstruction of a durable and sensitive palmar-specific anatomical structure. We successfully treated a 53-year-old male patient with a long-standing postburn contracture of all the right MCP joints and underlying palmar tissue. We performed contracture release and adductor pollicis myotomy and reconstructed the resultant palmar defect with a sensate medial plantar free flap to restore acute skin sensitivity and resurface the glabrous skin of the palm. The Kirschner-wire fixation utilized for stabilizing the extended MCP joints was maintained for 3 weeks after contracture release. The restored palmar skin and soft tissue improved the MCP joint movements, enabling grasping and pinching motions and thus restoring functionality of the operated hand.
Keywords: Surgical flaps, Hand, Burns, Contracture


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