Plastic surgery; its principles and practice . sixmonths.—i. Before operation. Note the limit of extension. 2 and 3. Twenty-onemonths after the transplantation of a whole-thickness graft. Note the complete extensionand flexion. replace the missing bone a piece of bone (Neuhauser) or cartilage may beimplanted under the skin, and later transplanted in a pedunculatedflap to the finger. In the few cases in which this is necessary mypreference is for cartilage. Contractiures.^—These may vary from slight flexion of one finge:to complete flexion of all the fingers, and is often associated withcontrac
Plastic surgery; its principles and practice . sixmonths.—i. Before operation. Note the limit of extension. 2 and 3. Twenty-onemonths after the transplantation of a whole-thickness graft. Note the complete extensionand flexion. replace the missing bone a piece of bone (Neuhauser) or cartilage may beimplanted under the skin, and later transplanted in a pedunculatedflap to the finger. In the few cases in which this is necessary mypreference is for cartilage. Contractiures.^—These may vary from slight flexion of one finge:to complete flexion of all the fingers, and is often associated withcontracture of the palm. The condition may be due to scarring ofthe skin alone without injury to the tendons, or the tendons mayalso be partially or totally destroyed. When the tendon is intactmultiple division of the scar has been frequently tried, with or withoutthe injection of fibrolysin, but in my experience the method is far fromsatisfactory. I have had very good results with whole-thickness grafts (after i i SURGERY OF THE EXTREMITIES 671. Fig. 798.—Contracture following a burn by electricity. Duration ten months.—I. Before operation. 2. Ten and one-half years after grafting. The graft has been ex-posed to the constant trauma incident to farm work. It has increased in size as the handhas grown larger, and has preserved its own characteristics. Hairs similar to those on thethigh, from which the graft was taken, are growing on it. The graft is pigmented andwrinkled, but is soft and movable with the surrounding skin. The functional result isexcellent. 123 4 Fig. 799.—Partial syndactylism due to trauma. Duration one year.—i and 2. Notethe inability to separate the middle, ring and little fingers, and the scar involvement. 3and 4. The result of several operations to deepen and widen the commissures. Comparethe ability to separate the fingers with that before operation. In this case the flaps weremore or less infiltrated with scar tissue. 672 PLASTIC SURGERY completely re
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