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First Palmar Intermetacarpal Flap for Congenital First Web Contracture: A Case Series

Diego Gonzalez-Morgado1, Vivian Sinclair2, Xiao F Shen3

  • 1Orthopaedic Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.

Microsurgery
|January 9, 2025
PubMed

Insights

The first palmar intermetacarpal flap effectively treats pediatric first web space contractures, improving hand function. This surgical technique shows promising clinical outcomes for moderate-to-severe cases.

Area of Science:

  • Hand surgery
  • Pediatric orthopedics
  • Congenital hand differences

Background:

  • Pediatric first web space contractures cause significant hand function disability.
  • Surgical techniques are crucial for managing these deformities.
  • The first palmar intermetacarpal flap is a recently described surgical approach.

Purpose of the Study:

  • To evaluate the clinical outcomes of the first palmar intermetacarpal flap.
  • To assess its efficacy in patients with congenital first web space contractures.

Main Methods:

  • A case series of ten patients with moderate-to-severe contractures was analyzed.
  • Surgical intervention utilized the first palmar intermetacarpal flap.
  • Key variables included pre- and postoperative first intermetacarpal angle (IMCA) and complications.

Main Results:

  • All ten patients (12 hands) showed improved IMCA post-surgery (median 20° to 40°).
  • Median follow-up was 25 months.
  • Minor complications included skin graft pigmentation and flap tip dehiscence in five cases.

Conclusions:

  • The first palmar intermetacarpal flap is a viable surgical option.
  • It effectively manages moderate-to-severe congenital first web space contractures.
Abstract

Keywords:
congenital handintermetacarpal flapmicrosurgerypediatric handweb contracture

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