Comparative analysis of length gain provided by five-flap z-plasty and double z-plasty techniques for correction of digital flexion contractures

Abstract

Introduction: Persistent postburn flexion contractions of the digits present challenging deformities. The surgical goal is to lengthen the linear scar band on the flexion surface of a finger through local tissue rearrangement using different z-plasty techniques. This study aimed to analyse the length gain and compare outcomes between 5-flap z-plasty and double serial z-plasty techniques for correcting digital flexion contracture.Patients & method: This retrospective study was conducted from November 2022 to January 2024 on patients who presented with digital flexion contractures caused by volar linear scar contracture and who needed surgical intervention. All patients who underwent correction via the 5-flap z-plasty or double z-plasty technique were categorized into two groups.Results: A total of 12 patients were included in this study. All patients successfully achieved complete release of their digital contracture in both groups. While there was a significant increase in the length of the contracture band and extensor lag angle postoperatively in both groups, the mean increase in band length for patients treated with five-flap Z-plasty was significantly greater than that for patients treated with double z-plasty (63.667 ± 13.125% vs. 41.333 ± 12.1764%, respectively).Conclusion: The 5-flap Z-plasty technique could be a more favourable alternative to the frequently used double z-plasty method due to its ability to achieve a superior rate of elongation in the contracture band and restore finger function when treating linear digital flexion contractures.