The bilobed flap — a better option for soft tissue release in the management of radial club hand

Objective: to establish that the bilobed flap as soft tissue release component for the radial club hand is superior to the z-plasty technique in type iii and iv radial club hands. methods: this study was conducted at the shifa international hospital,islamabad,pakistan,from 2009 to 2015,and comprised patients with radial club hands operated by a single consultant plastic surgeon. soft tissue release was performed at 08 months. the extremity was then casted for 08 weeks and kept in a long-arm cast for 3 to 6 months. results: twelve radial club hands of 9 patients treated successfully during the study period showed good to excellent results. z-plasty was used on the radial side to correct the soft tissue deficiency in 5(42%) hands,and a bilobed flap in 7(58%) hands for soft tissue rearrangement on the radial side. of all hands,1(8.3%) z-plasty flap developed partial flap necrosis and 1(8.3%) each developed infection and needed implant (kirschner wire removal),which were dealt with efficiently with no long-term sequelae. conclusion: the bilobed flap was found to be superior to the z-plastytechnique since the flap had better predictability and no tissue was wasted. © 2017,pakistan medical association. all rights reserved.