Objective To summarize the current research progress of finger flexion deformity caused by forearm flexor muscle lesions, providing a reference for clinical diagnosis and treatment. Methods The domestic and international literature about finger flexion deformity caused by forearm flexor muscle lesions was extensively reviewed. A summary analysis was conducted from the etiology and pathogenesis, diagnosis and differential diagnosis, and treatment methods. Results The three types of forearm flexor pathology leading to finger flexion deformity include Volkmann’s contracture, pseudo-Volkmann’s contracture, and congenital flexor muscle lesions with different pathogenesis. The diagnosis is mainly based on the patient’s medical history, clinical features, and imaging examinations, with attention paid to differential diagnosis. Currently, conservative treatment for such deformities is not very effective, and surgical treatment is mainly adopted. According to the causes and severity, options such as resection of the contracture band, resection of contracture band, release of compressed muscle (tendon), and flexor origin muscle sliding surgery, could be performed to correct hand deformities and restore hand function, and thus resulting in favorable outcomes. Conclusion Volkmann’s contracture, pseudo-Volkmann’s contracture, and congenital flexor muscle lesions causing finger flexion deformity have different causes and pathogenesis, which can be distinguished by carefully inquiring about the medical history, the clinical characteristics of the three, and imaging examinations, thereby selecting appropriate treatment methods.
Objective To investigate the effectiveness of the free fibular skin flap of the great toe in repairing finger flexion deformity due to scar contracture. Methods The clinical data of 12 patients with finger flexion deformity due to scar contracture treated with scar release and free fibular skin flap of the great toe between March 2022 and December 2024 was retrospectively analyzed. All patients had flexion deformity caused by scar contracture of finger joints after healing of skin defect scar. The duration of scar contracture ranged from 3 months to 2 years, with an average of 7 months. The active range of motion of the finger joint was 0°-10°, with an average of 8°. The range of skin flap was 2.0 cm×1.3 cm to 3.5 cm×2.5 cm. Results All 12 patients were followed up 6-12 months, with an average of 10.5 months. At last follow-up, the flexion deformity of the affected finger was completely corrected, and the active range of motion of the finger joint was restored to close to the healthy side (the distal finger joint was 30°-40°, with an average of 35°; the proximal finger joint was 80°-90°, with an average of 85°). The shape of the flap was plump, the texture was good, and the static two-point discrimination was 6-8 mm, with an average of 6.8 mm. According to the evaluation standard of upper limb function of Chinese Medical Association Hand Surgery Society, 9 cases were excellent, 3 cases were good, and the excellent and good rate was 100%. All wounds at donor sites healed by first intention, with no pain, ulcer or ulceration in toes, normal walking in shoes, and no influence on gait. Conclusion Free fibular skin flap of the great toe is an effective method to repair the finger flexion deformity due to scar contracture, which providing good cosmetic, motor, and sensory outcomes with low donor-site morbidity.
