Use of the 5-flap Z plasty in digital flexion contractures

The purpose of this article is to report the use of the 5-flap Z plasty in the management of long-standing flexion contractures of the proximal interphalangeal joint of the digits (the 5-flap Z plasty has been originally described by Hirshowitz et al for the lengthening of thumb web contractures). Nine fingers in 5 patients with Stern grade I and II contractures of the proximal interphalangeal joint were included. The defect following release of the contracture was covered with the 5-flap Z plasty and Kirschner wires temporarily maintained the corrected position. The extension lag was measured preoperatively and postoperatively. The preoperative extension lag ranged from 20 to 60 degrees (mean: 43.3 degrees). The improvement in extension lag ranged from 15 to 60 degrees (mean: 40.5 degrees). Minimal complications were encountered. The technique described is useful in the management of Stern grade I and II digital contracture.