Modified Farmer's Flap for Cosmetic Correction of Post-burn Small Finger Deformity: A Case Report

Childhood burn injuries can lead to persistent digital contractures and contour deformities that affect both function and psychosocial well-being. We report the case of a 17-year-old female patient with a longstanding post-burn contracture and cosmetic deformity of the small finger after a burn sustained at age two, initially treated conservatively with compression dressings. Years later, she presented with residual soft tissue atrophy and tethering with clinically apparent foreshortening and expressed concern primarily about the cosmetic appearance. A modified Farmer’s flap, traditionally described for hallux varus correction of the great toe, was adapted as a local rotational flap to address the soft tissue deficiency and restore contour after scar release. The procedure improved the overall appearance and contour of the small finger with a satisfactory cosmetic match using local tissue. At postoperative follow-up, the patient reported satisfaction with the aesthetic outcome; a decrease in small-finger range of motion was anticipated and accepted as a trade-off, and no complications were observed. This case demonstrates that Farmer’s flap principles may be adapted for selected post-burn hand deformities when cosmetic restoration is a primary goal and local tissue rearrangement is appropriate.