Mohan1, T. R. Nagarjuna2
ABSTRACT: BACKGROUND AND OBJECTIVES: Propeller flap is based on a vascular pedicle supplying a fascio cutaneous island of skin. It is used to reconstruct soft tissue defects. Flexion contractures are aesthetically deforming post burns sequalae. Various techniques are used to relieve the contractures such as V-Y plasty, X plasty and Z plasties. A propeller flap can also be used to relieve the contractures. Thus there is a need to study the effectiveness of propeller flap in reliving flexion contractures in comparison with conventional V-Y plasty, X plasty and Z plasties in terms of adequacy of release, coverage of vital areas, technical ease, splintage times, patient morbidity, aesthetics and flap survival. METHODS: 20 Patients with post burn flexion contractures of durations varying from 1-3 years were randomly selected. Release of the flexion contractures with subsequent cover of the raw areas thus created, with the propeller flap. No prospective comparative study was undertaken using other means of coverage. RESULTS: 1. Adequacy of release superior to Z plasty, compares with V-Y plasty, X plasty, inferior to SSG especially in deep contractures. 2. Coverage of vital areas superior to all techniques. 3. Technical ease compares favorably with all techniques. 4. Splintage times are obviated unless muscles are involved. 5. Aesthetics superior to SSG. 6. Flap survival is superior to all methods. CONCLUSIONS: Propeller flaps have a very good potential for release of flexion contractures compared to conventional techniques.
