OUTCOMES OF Z-PLASTY SURGERY IN FUNCTIONAL RESTORATION OF CONTRACTED FINGERS

Nguyen Thien Duc 1, 2 , Vo Thanh Toan 1, 2 , , Le Anh Tuan 1, 2 , Nguyen Phi Trinh 1, 2
1 Vietnam National University Ho Chi Minh City image/svg+xml
2 Thong Nhat Hospital image/svg+xml
* Corresponding author:

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DOI
10.63947/bvtn.v2i7.14
Published
2026-02-27
Issue Vol. 2 No. 7 (2026): Multimodal approaches in geriatrics
Section
Original Research
Categories
Research

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1.
Thien Duc N, Thanh Toan V, Anh Tuan L, Phi Trinh N. OUTCOMES OF Z-PLASTY SURGERY IN FUNCTIONAL RESTORATION OF CONTRACTED FINGERS. JHA [Internet]. Vietnam; 2026 Feb. 27 [cited 2026 Feb. 28];2(7):111–116. https://tcsuckhoelaohoa.vn/bvtn/article/view/182 doi: 10.63947/bvtn.v2i7.14
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Abstract

Finger contractures, resulting from burns, trauma, or congenital anomalies, often lead to significant functional impairment. Z-plasty is a versatile reconstructive technique used to release scar contractures while preserving local tissue characteristics. This study aimed to evaluate the functional outcomes of different Z-plasty techniques in the surgical release of contracted fingers. We conducted a prospective descriptive case series involving 31 patients (38 fingers) undergoing Z-plasty for digital contractures. Depending on the location and severity of the contracture, three Z-plasty techniques were used: five-flap, double-opposing, and single 60° Z-plasty. Patients were followed for a mean of 5.6 months. Primary outcomes included range of motion (ROM), web space angle, and DASH scores. Complications and patient satisfaction (VAS) were also assessed. All techniques demonstrated significant improvements in finger extension and flexion. Mean extension deficit improved from −35.4° to −8.1°, and flexion increased from 62.3° to 81.7° (P < .001). The five-flap Z-plasty achieved the greatest gain in web space angle (from 24.2° to 46.8°). DASH scores decreased significantly from 47.6 to 21.8 (P < .001), with patient satisfaction increasing from 4.2 to 8.1 on VAS. Minor complications occurred in 5 patients (16.1%), with no cases of flap necrosis or wound infection. Z-plasty is an effective and low-risk technique for releasing digital contractures and restoring hand function. Five-flap and doubleopposing Z-plasty provide greater functional improvement in web space contractures, while single Z-plasty remains effective for linear joint contractures. These techniques offer reliable outcomes without the need for skin grafting, supporting their continued use in reconstructive hand surgery.

Keywords

Z-plasty finger contracture five-flap Z-plasty web space release functional outcome scar revision hand surgery

References

  1. Aasi SZ. Z-plasty made simple. Plast Reconstr Surg. 2011;127(2):1193–1194. doi:10.1097/PRS.0b013e318205f292.
  2. Gümüş N. Management of scar contractures of the hand using Z-plasty. Turk Plast Surg. 2012;20(4):157–163. doi:10.1007/s00266-012-9821-1.
  3. Tucker SC, Aviram R, Massey MF. Reconstruction of severe hand contractures: an illustrative algorithm. Eplasty. 2011;11:e26. Published 2011 May 13. PMID: 21716730.
  4. Cho H, Kim EK, Lee JH, et al. Management of scar contractures of the hand: our therapeutic strategy and challenges. J Clin Med. 2024;13(5):1516. doi:10.3390/jcm13051516.
  5. Wallace DW, Moltaji S, Rogers AD. Operative management of first web space contracture: comparison of four-flap and five-flap Z-plasties. J Hand Surg Am. 2023;48(9):835.e1–835.e7. doi:10.1016/j.jhsa.2023.05.008.
  6. Bibi J, Khan M, Ahmad F, et al. Effectiveness of 60° Z-plasty incision in treating digital contractures. J Postgrad Med Inst. 2025;39(1):10–14. https://www.jpmi.org.pk/index.php/jpmi/article/view/3765.
  7. Eloteify M, El-Gendi A, Mahmoud MM. Double opposing five-flap Z-plasty in the correction of post-burn contracture: a simplified approach. Burns Open. 2024;8(2):78–83. doi:10.1016/j.burnso.2024.01.003.
  8. Jahanabadi S, Khoshnevis S, Yazdanpanah G, et al. Local flap reconstruction of burn contractures in the hand: a clinical experience. Burns Trauma. 2024;12:tkad080. doi:10.1093/burnst/tkad080.
  9. Kundu R, Sharma R, Rajput A, et al. Surgical outcomes of burn contracture release on the hand: a retrospective review. Hand Microsurg. 2023;12(2):121–127. doi:10.5152/handmicrosurg.2023.23006.
  10. Zito PM, Akhondi H. Z-Plasty. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK507775/

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© 2026 The Author(s). Published by Journal of Health and Aging.

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