J Hand Microsurg
DOI: 10.1055/s-0043-1761221
Surgical Technique

Double Stiletto Flap for Soft Tissue Cover as a Firebreak Following Contracture Release of Digits and Full-Thickness Grafting: A Surgical Technique

Samuel C. Raj Pallapati
1   Department of Hand Surgery, Dr Paul Brand Centre for Hand Surgery, Leprosy, Reconstructive Surgery, and Peripheral Nerve Surgery, Christian Medical College Hospital, Vellore, Tamil Nadu, India
,
1   Department of Hand Surgery, Dr Paul Brand Centre for Hand Surgery, Leprosy, Reconstructive Surgery, and Peripheral Nerve Surgery, Christian Medical College Hospital, Vellore, Tamil Nadu, India
› Author Affiliations

Abstract

Contracture release followed by full-thickness skin grafting is often performed while releasing severe contracture of the digits. We report a technique for flexion contracture of the finger, by using two triangular flaps from either side of the digit as a firebreak over the proximal interphalangeal (PIP) joint while using a skin graft following contracture release. We reviewed the medical records of patients who underwent contracture release at our institution from January 2018 to July 2021, and this technique was used for the release of flexion contracture of the five digits belonging to four patients. Our technique used triangular flaps from either side of the digit, which were rotated and brought over the PIP region, and hence, a single sheet of graft spanning the PIP joint is avoided. We believe that this acts as a firebreak and thus reduces the recurrence of contracture at the PIP joint.

Ethical Approval

Approved by the Institutional Review Board, Christian Medical College Vellore, Tamil Nadu, India (IRB Min No. 14169(Retro) dated July 28, 2021).




Publication History

Article published online:
13 March 2023

© 2023. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

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