Lateral chest wall fasciocutaneous flaps in the management of burn contractures on the dorsum of the hand

Summary Post-burn contracture involving the dorsum of the hand with hyperextension and volar subluxation of the metacarpophalangeal joints of the fingers plus adduction contracture of the thumb is a crippling disability. Adequate release of such contractures leaves raw areas on the dorsum of the hand, forgers and in the first web space. Fasciocutaneous flaps from the contralateral chest wall (the lateral thoracic flap and the subaxillary flap) have been used in eight patients. The comfortable fixation position, the non-hairy nature of the flaps, the excellent vascularity and a concealed donor site, which can often be primarily closed, make these flaps attractive for the defects. Within a follow-up period of five to twelve months, all the patients returned to their previous vocation.