Extension contracture due to extensor tendon adhesions after trauma is difficult to improve because re-adhesion and loosening of the extensor tendon can be difficult to treat even after extensor tenolysis.
In this study, we used a perforator adipofascial flap (PAFF) as a gliding bed during extensor tenolysis to prevent tendon re-adhesions, in addition to joint mobilization.
This technique was performed on four fingers in four cases of post-traumatic extension contracture: two in the middle finger proximal interphalangeal (PIP) joint, one in the little finger metacarpophalangeal (MP) joint, and one in the thumb MP joint.
In one case of primary tenolysis, good improvement in the range of motion was observed. The other three patients underwent multiple surgeries; improvement in the range of motion was slightly lower, but re-adhesion was prevented, and extension range of motion was maintained and improved.
PAFFs were considered useful not only in preventing re-adhesion of the extensor tendon, but also in reducing extensor tendon loosening because a sufficient amount of the PAFF was able to be inserted under the extensor tendon.
