Management of Scar Contracture of the Fingers with Percutaneous Needle Aponeurotomy and Fat Lipofilling

Abstract

Background: Scar contractures of the fingers represent a major functional and aesthetic burden to many patients with hand injury. Managing such condition is often challenging and various techniques have been proposed, with flap-based techniques being the conventional options. Percutaneous Needle Aponeurotomy (PNA) combined with lipofilling represent a novel, non-invasive method for managing scar contractures. Methods: This prospective study included 10 patients with scar contractures of the fingers who were managed with PNA and lipofilling at a single center from March 1st, 2015 till March 1st, 2016. Six patients had postburn scars and 4 patients had post-traumatic scarring. Results: All patients had significant improvement in contractures postoperatively at the median follow-up, the mean improvement of contracture was 21 degrees (± 9 degrees) for the MP joint, and 31 degrees (± 12 degrees) for the PIP joint. Functional improvement was recorded in 6 out of 8 patients (75%), and cosmetic improvement was reported by 9 out of 10 patients (90%). Conclusion: PNA with lipofilling is a novel, safe and effective means for managing scar contractures of the hand.