[Current techniques and indications of pedicled groin flap for hand surgery. Apropos of 100 cases]. / Technique et indications actuelles du lambeau inguinal pédiculé en chirurgie de la main. A propos de cent observations.

Based on an analysis of the anatomical and physical data reported in the literature, the authors describe their personal technique based on an experience of 100 pedicled inguinal flaps. The authors define the current indications for this flap in reconstructive hand surgery. The quality of pedicled inguinal flaps makes this procedure a technique of choice in the emergency treatment of wounds of the hand.

[The inguinal pedicle flap in emergency traumatic hand surgery: value of the long pedicle permitting an early rehabilitation]. / Le lambeau inguinal pédiculé en chirurgie d'urgence de la main traumatique: intérêt du pédicule long permettant une rééducation précoce.

The main drawbacks of the use of a groin pedicle flap in emergency surgery for hand injuries are the declivitous position of the upper limb with a tendency towards oedema and the difficulty of instituting early rehabilitation because of the fact that the injured hand is fixed to the abdomen. Based on an extensive experience of 76 emergency flaps out of more than 100 flaps performed over the last ten years, the authors describe their flap raising technique which allows the formation of a long, closed tube compatible with early rehabilitation and also allowing the possible use of splints.

Simple arthrolysis for flexor rigidity of the proximal interphalangeal joint.

The authors report 19 cases of simple arthrolysis of the proximal interphalangeal joint for flexion rigidity. Their cases were limited to isolated lesions of the joint without any flexor or extensor tendon involvement. The technique is described, and the importance of postoperative physical therapy is stressed. The results in these cases, in contrast with those in complicated cases of rigidity, are very satisfactory. The etiology is primarily sprains and dislocations of the proximal interphalangeal articulation, immobilized for too long a time in flexion (in the so-called "functional position").

Two-step reconstruction of the flexor tendons (Hunter's technique) in the treatment of fingers "en crochet".

The authors used Hunter's technique to treat 16 cases of fixed-flexion deformity of the finger (with irreducible flexion of the joint greater then 70 degrees), secondary to lesions of the flexor tendons. The flexion deformity was corrected in 11 of the 16 cases, and active movement greater than 70 degrees was obtained in only 7 cases. Technical difficulties (particularly cutaneous problems), frequent complications, prolonged reeducation are the reasons that the indications for its use are exceptional, and why there is need for excellent cooperation by the patient.