Asymmetric spindle skin harvesting combined with continuous Z skin grafting: experience in correcting metacarpophalangeal joint dorsiflexion deformities

Dorsiflexion deformity of the metacarpophalangeal (MCP) joint is a common complication of hand burns, often leading to severely compromised hand function and aesthetics. Traditional surgical techniques typically involve extensive skin harvesting and grafting with splicing, which may increase procedural risks and donor site morbidity, as well as complications such as graft failure, infection, and necrosis. These limitations highlight the need for a surgical approach that can effectively correct scar contracture deformities while minimizing operative challenges and risks, improving graft survival, and promoting functional recovery. Based on the clinical surgical outcomes of 12 patients, we propose a novel technique involving asymmetric spindle-shaped excision combined with continuous Z skin grafting. This approach aims to optimize therapeutic outcomes through personalized scar excision and contracture release, utilizing asymmetric fusiform skin removal, an ultra-tension-reducing suture technique, continuous Z skin grafting, and functional fixation. This article outlines the surgical procedure, technical points, and clinical effects of the proposed method. Ultimately, this method effectively corrects MCP joint dorsiflexion deformities in burn patients, significantly improving both hand function and appearance.