Treatment of Camptodactyly With Radial Longitudinal Flap Versus Full-Thickness Skin Graft

Description

The goal of this randomized clinical trial is to compare two surgical techniques used for skin coverage after surgical correction of camptodactyly, a condition in which one or more fingers remain bent and cannot be fully straightened. The study will include children and adolescents with camptodactyly who have a proximal interphalangeal joint flexion contracture of 30 degrees or more and an indication for surgical treatment. The main question the study aims to answer is: \- Does a radial longitudinal flap provide better gain and maintenance of finger extension six months after surgery compared with a full-thickness skin graft? The study will also evaluate: * Movement of the affected finger; * Recurrence of the deformity; * Surgical complications; * Hand function; * Patient and/or parent or caregiver satisfaction; * Adherence to rehabilitation and nighttime splint use; * Overall surgical outcome. Researchers will compare radial longitudinal flap and full-thickness skin graft to determine whether the radial longitudinal flap provides better maintenance of finger correction. Participants will: * Undergo the surgical treatment indicated for camptodactyly, with skin coverage using either a radial longitudinal flap or a full-thickness skin graft, according to randomization; * Be evaluated before surgery and at 2, 4, 8, and 12 weeks and 6 months after surgery; * Have movement of the affected finger assessed using standardized goniometry; * Follow the postoperative rehabilitation protocol, including occupational therapy and nighttime extension splint use; * Complete assessments of hand function and satisfaction at the scheduled evaluation periods. * Approximately 42 eligible fingers will be randomized, with 21 fingers allocated to each treatment group. If a participant has more than one eligible finger, each eligible finger may be randomized independently.

Interventions

• Radial Longitudinal Flap (Procedure)
  Surgical coverage of the skin defect created after standardized release of the contracted structures in patients with camptodactyly, using a radial longitudinal flap raised from the radial aspect of the affected finger and transposed to cover the resulting volar defect.
• Full-Thickness Skin Graft (Procedure)
  Surgical coverage of the skin defect created after standardized release of the contracted structures in patients with camptodactyly, using a full-thickness skin graft. The graft will be harvested from the wrist flexion crease or hypothenar region according to the standardized surgical protocol.

Eligibility criteria

Conditions

Locations

• AACD — São Paulo, São Paulo, Brazil