FDMA-based kite flap reconstruction for post-burn first web space contractures: A retrospective study: Treatment of first web space burn contractures

Cenk Melikoglu

doi:10.28982/josam.8495

Authors

Cenk Melikoglu Department of Plastic Surgery, Ekol Hospitals, Izmir, Turkey https://orcid.org/0000-0002-6944-721X

DOI:

https://doi.org/10.28982/josam.8495

Keywords:

first web space, burn contracture, FDMA, kite flap, web opening

Abstract

Background/Aim: Post-burn first web space contractures significantly impair thumb abduction and overall hand function. This study aimed to evaluate the short- to mid-term clinical outcomes of a first dorsal metacarpal artery (FDMA)–based kite flap following complete release of post-burn first web space contractures.
Methods: This retrospective case series included five patients with post-burn first web space contracture. In all cases, complete release of the contracture was performed, followed by reconstruction of the resulting defect using an FDMA-based kite flap. In one patient, a concomitant fifth-finger flexion contracture was corrected with a cross-finger flap during the same session. The primary outcome measure was first web space opening, assessed preoperatively and postoperatively using a goniometer in a standardized clinical position.
Results: The mean preoperative first web space opening was 70.0 (3.5), which increased to 90.0 (0.0) postoperatively, corresponding to a mean improvement of 20.0 (3.5). Follow-up ranged from 5 to 7 months. In all patients, the achieved web space opening was preserved throughout follow-up, and no residual or recurrent contracture was observed.

Conclusion: Reconstruction of post-burn first web space contractures using an FDMA-based kite flap after adequate release provides reliable restoration and maintenance of web space opening in the short to mid-term. This technique represents a stable and functional reconstructive option in selected patients when a true soft tissue defect is present after contracture release.

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