Square Flap Method for Reconstruction of Palmar and Dorsal Web Space Burn Contractures

Postburn web space contractures can result in serious in hand function impairments along with cosmetic disfigurement. In our study, we introduce our experience with the use of the square flap method to release palmar or dorsal web space contractures.

From March 2019 to May 2021, the square flap method was conducted in 12 patients with 13 digital web space contractures.

The average patient's age was 6 years old (range, 2.5-16 years old). The most common affected web space was the second web. Web contractures were palmar in 9 patients and dorsal in 4 patients. The average duration of scar maturity was 13.6 months (range, 8-24 months). All the square flaps were effective in releasing the web space contracture and healed uneventfully with no postoperative complications. The average follow-up period was 11 months (range, 2-24 months). All patients or their parents were satisfied with the procedure outcomes in terms of independent finger function and esthetic appearance.

The square flap technique is safe, reliable, and effective in management of both dorsal and palmar interdigital web scar contracture. It completely eliminates the contracture and restores commissural anatomy with good cosmetic outcomes.