Muhammad Omar Afzal, Moazzam Nazeer Tarar, Yaseen Rafi.
Reconstruction of the Post Burn First Web Space Contractures of Hand with Square Flap Efficacy of the technique.
Pak J Med Health Sci Jan ;13(1):176-80.

Background: Square flap theoretically offers 2.82 times increase in the length of contracted surface as compared to maximum of 2.23 times of z-plasties. Aim: To assess the effectiveness of this technique for the most critical first web-space contracture, this study is done to find its efficacy. Methods: Case series was done in department of plastic surgery, JHL. 30 patients with first web-space contractures were included. Pre and post angle and length, and efficacy, as determined by postop angle of ≥ 90º, were recorded. Mean and standard deviation of numerical variables while frequency and percentages of qualitative variables were calculated. Data stratification and post stratification chi-square test was applied to check effect modifier. Results: Mean age was 17.90+/- 9.271 years. Male patients were 19, while female were 11. Mean duration of contracture was 1.523+/-0.424 years. Mean pre-operative length was 2.330 +/- 0.4921 cm, while post-operative length was 4.470 +/- 0.8579 cm. Mean post-operative gain was 1.9433+/- 0.16121.P re-operative angle had a mean of 48.20+/-3.576 and post-operative 90.90 +/-2.917. Efficacy was 93.33%. Post stratification chi-square test showed p > 0.05 for all variables. Conclusion: Square flap is more effective than other techniques described in literature for reconstruction of first web-space contractures.

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