Publication Details
Abstract
This study evaluates the clinical application and effectiveness of an innovative 'L'-shaped suturing technique in Limberg flap surgery for managing post-burn linear scar contractures on the plantar surface of the fifth toe. All 33 patients underwent surgical correction, with scar sizes ranging from 5 cm² to 13 cm² (χ² = 7.01; P = 0.002). The 'L'-shaped suturing technique was specifically designed to optimise tension distribution along the margins of the flap, reduce strain on the wound edges, and improve alignment, all of which are critical for functional recovery in the plantar region. Immediate postoperative outcomes demonstrated the restoration of normal toe mobility and a full range of motion in all patients. Early postoperative complications were minimal, occurring in only three cases (9.1%), including wound suppuration in two patients (6.1%) and marginal wound dehiscence in one patient (3.0%). All complications were successfully managed without compromising flap viability. Long-term follow-up over 12–18 months revealed contracture recurrence in two patients (6.1%), indicating the durability and reliability of this reconstructive approach. Flap viability and postoperative tissue health were systematically assessed using skin thermometry to monitor microcirculation, as well as measurement of tissue oxygen partial pressure, to ensure adequate perfusion. These evaluations confirmed stable flap integration, satisfactory vascularisation, and maintenance of tissue viability in weight-bearing areas of the foot. These results show that the 'L'-shaped suturing modification in Limberg flap reconstruction is an effective, reproducible and safe surgical strategy for treating post-burn linear scar contractures of the fifth toe. This method offers rapid functional recovery, low complication rates and minimal recurrence, thus supporting its adoption in the clinical setting for complex plantar reconstructive challenges.