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. CONCLUSIONS The bilobed flap was found to be superior to the z-plastytechnique since the flap had better predictability and no tissue was wasted.