Chronic Postburn Palmar Contractures Reconstruction Using the Free Lateral Thoracic Perforator Flap

Purpose: Chronic flexion contractures of the palm of the hand impair hand function considerably and cause a poor aesthetic appearance. Various reconstructive methods have been used for the treatment. However, satisfactory aesthetic and functional results are difficult to achieve. In the present study free the lateral thoracic flap was used in a number of cases suffered from severe palmar flexion contractures due to burn injuries. Here, the experience, technique and follow-up results are presented. Methods: 4 patients admitting to our department with palmar flexion contracture were reconstructed with free lateral thoracic flap from 2007-2010. All were men and ranging in age from 21 to 22 years old (average, 21.2 years). In all cases, different parts of palmar region were covered. In operation, the patient was placed in supine position under general anestesia. In all cases anastomosis was done to radial artery and concomitant vein. Donor sites were closed primarily. Result: The transplanted flaps survived with satisfactory recovery in function and appearance. In one case, transient venous insufficiency was observed and resulted in possible increase in flap thickness. Grasp function of the hand was dramatically improved The floow-up period ranged from 8 to 14 months. In one case, the flap required debulking. Postoperative follow-up revealed no marked donor site morbidity. Coclusion: In the correction of severe postburn hand deformities, the aggressive surgical release of soft tissue, tendons, and joints along with flap coverage is imperative. The the lateral thoracic perforator flap provides a thin, pliable tissue for covering the exposed tendons and vessels, with a good color and texture match. Because of these advantages, the use of the lateral thoracic flap in the treatment of challenging palmar burn contractures is recommended.