{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T10:57:07Z","timestamp":1793271427504,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>In the serious forms of Dupuytren disease, passive extension during surgery often results in unmasking a loss of skin substance that makes primary closure impossible. Our objective in this study was to describe and assess the therapeutic possibilities of a 3 local flaps surgical approach in serious forms of Dupuytren disease, using the lateral skin expansion because of the cord. A cadaveric study was carried out on 12 adult nonembalmed, fresh frozen hands. For each specimen, a loss of skin substance was simulated on the palmar side of the fifth finger at the level of the proximal digital flexion crease. Coverage involved an incision delineating 3 distinct local flaps: a radially based quadrangular palmar flap, triangular proximally based laterodigital flap, and a distally based triangular web space flap. For a defect reaching up to 40% of the palmar surface of the first phalanx (P1), this 3-flap combination allowed us to fill in skin loss with a tension-free closure. Then we led a clinical study among 10 patients suffering from Dupuytren contracture, Tubiana, and Michon classification stages from II to IV. For those patients who all showed perioperative inadequate skin coverage, we used the 3-flap plasty. No skin necrosis occurred. This reliable technique using a \u201ccascade\u201d of local flaps makes it possible, in serious forms of Dupuytren disease, to both easily access the palmar and digital portions of the cord and to achieve closure.<\/jats:p>","DOI":"10.1097\/bth.0000000000000271","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T14:43:08Z","timestamp":1577198588000},"page":"89-97","source":"Crossref","is-referenced-by-count":5,"title":["Skin Expansion Due to the Dupuytren Cord Allows to Design Local Flaps to Facilitate Skin Closure in Severe Cases: The 3-flap: Surgical Technique and Clinical Evaluation"],"prefix":"10.1097","volume":"24","author":[{"given":"H\u00e9l\u00e8ne","family":"Le Gall","sequence":"first","affiliation":[{"name":"Clinique Pasteur, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Dautel","sequence":"additional","affiliation":[{"name":"Chirurgie de la Main, Centre Chirurgical \u00c9mile Gall\u00e9, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"pt 1","key":"R1-20230901","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0363-5023(87)80043-6","article-title":"Dermofasciectomy and full-thickness grafts in the treatment of Dupuytren\u2019s contracture","volume":"12","author":"Ketchum","year":"1987","journal-title":"J Hand Surg"},{"key":"R3-20230901","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S0753-9053(82)80001-X","article-title":"Lateral digital rotation flaps in the treatment of forms of Dupuytren\u2019s contracture. 141 cases","volume":"1","author":"Razemon","year":"1982","journal-title":"Ann Chir Main"},{"key":"R4-20230901","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S1297-3203(01)00034-8","article-title":"Treatment of recurrent Dupuytren\u2019s disease. 1992","volume":"20","author":"Hueston","year":"2001","journal-title":"Chir Main"},{"key":"R5-20230901","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/0266-7681(91)90135-B","article-title":"Two flaps to resurface the basal flexion-crease of the finger area","volume":"16","author":"Harrison","year":"1991","journal-title":"J Hand Surg Br"},{"key":"R6-20230901","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jhsb.2006.09.015","article-title":"The palmar intermetacarpal flap in Dupuytren\u2019s contracture","volume":"32","author":"Pelissier","year":"2007","journal-title":"J Hand Surg Eur Vol"},{"key":"R7-20230901","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1097\/00006534-196740060-00010","article-title":"The zig-zag volar-digital incision for flexor-tendon surgery","volume":"40","author":"Bruner","year":"1967","journal-title":"Plast Reconstr 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grafts","volume":"5","author":"Colson","year":"1960","journal-title":"Ann Chir Plast"},{"key":"R13-20230901","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1177\/1753193408095353","article-title":"Anatomical study of the palmar intermetacarpal perforator flap","volume":"34","author":"Pelissier","year":"2009","journal-title":"J Hand Surg Eur Vol"},{"key":"R14-20230901","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0007-1226(51)80006-7","article-title":"Incisions for plastic and reconstructive (non-septic) surgery of the hand","volume":"4","author":"Bruner","year":"1951","journal-title":"Br J Plast Surg"},{"key":"R15-20230901","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1097\/01.PRS.0000122207.28773.56","article-title":"The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation","volume":"113","author":"Draaijers","year":"2004","journal-title":"Plast Reconstr 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