THREE Y-V FLAP FOR RELEASING OF FIRST WEB SPACE CONTRACTURE OF THE HAND

BackgroundFirst web space contracture could be caused by burns, infection, trauma, paralytic, arthritis, congenital abnormality, and abnormal immobilization that led to functional limitation of the surgical procedure, including three Y-V flaps. ObjectivesTo review the outcome of patients with a contracture of the first web space that released contracture using 3 Y-V flaps and evaluate the opening degree of the first web space angle. Patients and MethodsTwenty-eight patients with post-burn contracture of the first web space at Sulaimani Burn and Plastic Surgery Hospital were included from April 2019 to April 2022. The patients were treated using the 3 Y-V plasty technique, and pre-/post-operative angles were measured with a goniometer. ResultsThe mean age of the studied patients was 36.9±9.0. The angle was improved with a preoperative mean value of 39.26 to 58.75 after the operation. Among four recurrent contracture cases, three were due to electrical burns, while another was caused by flap necrosis. Small pieces of skin graft were not the cause of recurrence in this study. ConclusionThree Y-V plasty is a successful surgical intervention in reconstructing the first web space contracture. However, we suggest excluding patients who cannot use their hands in their daily activities, especially when the contracture is due to electrical burn and associated with nerve injury/muscle contracture; correcting these problems before releasing the contracture is better.