When reconstructing a palmar skin defect after the release of digital flexion contracture, flaps are more useful than skin grafts for preventing recurrent contracture.
There are various flaps that can be used to reconstruct such defects, including digito-lateral flaps, palmar advancement flaps, cross finger flaps, etc.
I examined whether the dorsal skin extends if digital flexion contracture remains untreated for a certain period and developed a new surgical technique, which involved the use of a bilobed propeller flap that was composed of dorsal and lateral skin paddles and contained the dorsal branch of the digital artery.
This new type of flap surgery was performed in 4 cases, including one case of distal interphalangeal joint contracture and 3 cases of proximal interphalangeal joint contracture. The maximum diameter of the palmar skin defects was 15 mm, and additional skin grafts were only required in one case.
All of the flaps completely survived, and the flexion contracture was improved in all cases.
I conclude that the bilobed propeller flap described in this study should become the first-choice treatment for palmar skin defects that occur after the release of digital flexion contracture.
