Medial Ankle Dorsiflexion Contractures and Techniques for Their Treatment

Abstract

Burns and scars of the ankle anterior surface and dorsal foot restrict joint dorsi extension, walking, the wearing of shoes, and present a severe cosmetic defect. In children, foot development is delayed. Early reconstruction is therefore indicated along with simultaneous correction of all contractures and deformities. Scars form a fold, which is the scar surface surplus. The real contracture cause is the scar surface deficit in length. The presence of scar surface surplus in width allows for contracture elimination with local flaps. Treatment with triangular flaps does not allow for complete contracture release. Trapezoid-flap plasty is more efficient per se or in combination with skin transplantation. Rough mature scars undergo excision through an intermediate layer and wounds are covered with whole skin transplants.