Dynamic Hand Pain from Generalized Skin Tightness Treated with First Webspace Release and Resurfacing

Contractures from burns or other trauma generally manifest as discrete areas of skin deficiency or localized scar bands in the hand, and are treated successfully with release and resurfacing of the affected area. We report a case of generalized bilateral skin tightness in the hand from severe childhood burns, with no obvious localized area of contracture, manifesting with pain and numbness when making a fist and with certain activities. This was treated with release and resurfacing of the first webspace with bilateral free lateral arm flaps as well as endoscopic carpal tunnel release, resulting in increased laxity of skin throughout both hands, and resolution of dynamic symptoms with activity.