Keywords
hand
Z-plasty
child
How to Cite
Abstract
Introduction :
Hand flanges are retractions of the soft tissues bridging the joints. The aim of this study was to describe the epidemiological, etiological and therapeutic aspects of hand flanges in children in our department.
Patients and methods :
This was a retrospective cross-sectional study, conducted over a 23month period from January 1st, 2020 to November 30th, 2021, on children treated for hand flange in our department.
Results :
We collected 16 cases of retractile hand flange. The mean age at surgery was 4.37 years. Male predominance was noted, with a sex ratio of 3. Etiologies were largely dominated by burns, found in 68.7% of cases. Pure digital retractions were the most frequent type, found in 62.5% of cases. A Z-plasty was performed in 75% of cases. Total skin grafting was performed in 31.25% of cases. Surgical site infection was the most frequent postoperative complication, occurring in 12.5% of cases. The functional result was highly satisfactory in 68.75% of cases.
Conclusion :
Hand flanges result from the after-effects of thermal burns, most often in infants and children. Z-plasty, often combined with total skin grafting, produces satisfactory results.
References
1. Téot L, Brancati A, Otman S, Lebreton F. Traitement chirurgical des séquelles rétractiles et esthétiques de la main brûlée. Lett Méd Phys Réadapt. 2011;27:115-9.
2. Chateau J, Guillot M, Zevounou L, Braye F, Foyatier J-L, Comparin J-P, et al. Is there any place for spontaneous healing in deep palmar burn of the child?. Ann Chir Plast Esthet. 2016;7p.
3. Barani C, Brosset S, Person H, Guillot M, Braye F, Voulliaume D. Prise en charge des séquelles de brûlure palmaire chez l’enfant, à propos de 49 cas. Ann Chir Plast Esthet. 2020;7p.
4. Kraemer MD, Jones T, Deitch EA. Burn contractures: incidence, predisposing factors, and results of surgical therapy. J Burn Care Rehabil. 1988;9(3):261-5.
5. Lordier A : Epidémiologie des accidents chez l’enfant. Rev Pediat, 34 : 1545-55, 1984.
6. Albertyn R, Bickler S, Rode H: paediatric burn injuries in Sub Sahara Africa: An overview. Burns, 32: 605-12, 2006.
7. Sankale-Diouf AA, Wandaogo A, Tekou H, Fall I, Ndoye M: les cicatrices rétractiles de la main brûlée chez l’enfant: Une revue de 79 cas. Ann Chir Main, 18: 21-7, 1999.
8. Sherif MM, Sato RM. Severe thermal hand burns — factors affecting prognosis. Burns Incl Therm Inj 1989;15(1):42—6.
9. Barret JP, Desai MH, Herndon DN. The isolated burned palm in children: epidemiology and long-term sequelae. Plast Reconstr Surg 2000;105(3):949 - 52.
10. Goffinet L, Breton A, Gavillot C, Barbary S, Journeau P, Lascombes P, et al. Traitement chirurgical initial des brûlures de la main de l’enfant. Rev Ann Burns Fire Disasters 2015;28(3):196 - 204.
11. Vasseur C, Martinot V, Pellerin P, Herbaux B, Debeugny P. Les brûlures palmaires de la main de l’enfant 81 observations. Ann Chir Main Memb Super 1994;13(4):233 - 9.
12. Kibadi K., Moutet F. Traitement des séquelles de brûlures de la main dans les pays à ressources limitées ; notre expérience en république démocratique du congo. Annals of Burns and Fire Disasters - vol. XXVIII-n. 1 - March 2015.
13. Hundeshagen G, Zapata-Sirvent R, Goverman J, Branski LK. Tissue rearrangements: the power of the Z-Plasty. Clin Plast Surg 2017;44(4):805—12.
14. Ettalbi S, ibnouzahir M, Boukind H et al.: l’apport de la greffe de peau totale dans le traitement des séquelles des brulures de la main : A propos de 14 cas. Ann Burns Fire Disasters, 20: 181-4, 2007.
15. Revol M, Binder Jp, Danino A, May p, Servant JM: Manuel de chirurgie plastique, reconstructive et esthétique. 2ème édition révi- sée et augmentée. Sauramps medical, 881, paris, 2009.
16. Chandrasegaram MD, Harvey J. Fullthickness vs split-skin grafting in pediatric hand burns — a 10-year review of 174 cases. J Burn Care Res 2009;30(5):867—71.
17. Prasetyono TOH, Sadikin PM, Saputra DKA. The use of split-thickness versus fullthickness skin graft to resurface volar aspect of pediatric burned hands: a systematic review. Burns 2015;41(5):890—906.
18. Sankale-Diouf AA, Wandaogo A, Tekou H, Fall I, Ndoye M. Les cicatrices rétractiles de la main brûlée chez l’enfant : une revue de 79 cas. Ann Chir Main Memb Super 1999;18(1):21—7.
19. Afifi AM, Mahboub TA, Ibrahim Fouad A, Azari K, Khalil HH, McCarthy JE. Active range of motion outcomes after reconstruction of burned wrist and hand deformities. Burns J Int Soc Burn Inj 2016;42(4):783-9.
Metrics
Downloads
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 A Adoum, M Dalatou, M Dingamnodji, M Ali, O Bachar Loukoumi, P Djaba, M Issoufou, A Abdoul Wahab, B Souna