Application of a Serrated Palmar Promoted Flap to Treat Camptodactyly

Abstract

Objective: Most camptodactyly patients require surgical treatment with skin-grafting, but the result remains unsatisfactory. The serrated palmar promoted flap was explored to treat camptodactyly as a new strategy for surgical treatment. We will make a retrospective analysis of the treatment effect after serrated palmar promoted flap. Methods: A total of 12 children (five males and seven females) with camptodactyly, who had a mean age of 5.7 years old, were treated with serrated palmar promoted flaps between 2013 and 2016 in our department. Five children had little finger involvement, while seven children had multiple digital involvement. All patients (20 fingers) received a serrated palmar promoted flap, a zigzag incision was made in the lateral side, and a V-Y flap was designed in the palmar. Then, the abnormal subcutaneous fibrous cords were cut, and the palmar flap was promoted to distal end, accompanied by PDP joint extension. Skin grafting was also performed for some severely contracted fingers. The total passive motion (TPM) and total active motion (TAM) of the proximal interphalangeal joints were preoperatively measured and calculated at each follow-up. Results: At postoperative follow-up 18 months, all flaps survived. All digitals met the cosmetic and function requirement, and the flexion and extension of the digitals were significantly improved. The mean TPM and TAM was 41 and 25 degrees preoperatively, respectively, and 95 and 65 degrees at final follow-up, respectively. One patient exhibited adhesion after surgery, but improved after functional exercise. Conclusion: The application of a serrated palmar promoted flap to treat camptodactyly is a simple and practical method, which results in minimal trauma and good function. This procedure is suitable for patients with moderate-severe contractures.