Purpose
The ideal web reconstruction for syndactyly requires both satisfactory function and
aesthetic appearance. In this study, we report a dorsal hexagon local flap with adequate
size and that leaves most of the scars in the interdigital space.
Methods
Between June 2015 and June 2017, 16 patients (10 males and 6 females) with 22 syndactylies
underwent surgical reconstruction using the dorsal hexagon local flap technique. All
patients had simple syndactyly. The postoperative evaluation included the quality
of scarring, the extent of flexion and extension deformity, web creep, lateral flexion
deformity, and rotational deformity of the digit.
Results
All flaps survived and there were no postoperative complications. All patients achieved
satisfactory interdigital commissure depth. During 12 to 34 months of follow-up, no
case of flexion contracture or web creep after reconstruction was noted.
Conclusions
The dorsal hexagon local flap is an alternative method for syndactyly reconstruction.
Type of study/level of evidence
Therapeutic IV.
Key words
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References
- Developmental biology and classification of congenital anomalies of the hand and upper extremity.J Hand Surg Am. 2010; 35: 2066-2076
- A systematic review and comparison of outcomes following simple syndactyly reconstruction with skin grafts or a dorsal metacarpal advancement flap.J Hand Surg Am. 2017; 42: 34-40
- The open finger technique for the release of syndactyly.J Hand Surg Br. 2001; 26: 4-7
- Congenital anomalies of the hand and forearm.in: 1st edition. Plastic Surgery. Vol. 8. WB Saunders, Philadelphia1990: 5213-5279
- V-Y dorsal metacarpal flap: a new technique for the correction of syndactyly without skin graft.Plast Reconstr Surg. 1998; 101: 1861-1866
- Dorsal pentagonal island flap: a technique of web reconstruction for syndactyly that facilitates direct closure.Hand Surg. 2004; 9: 245-252
- Hourglass dorsal metacarpal island flap: a new design for syndactylized web reconstruction.J Hand Surg Am. 2008; 33: 905-908
- Dorsal pentagonal local flap: a new technique of web reconstruction for syndactyly without skin graft.Aesthetic Plast Surg. 2011; 35: 530-537
- Single-stage separation of 3- and 4-finger incomplete simple syndactyly with contiguous gull wing flaps: a technique to minimize or avoid skin grafting.J Hand Surg Am. 2017; 42: 257-264
- The use of a dorsal double-wing flap without skin grafts for congenital syndactyly treatment: a STROBE compliant study.Medicine (Baltimore). 2017; 96: 1-6
- The use of an hourglass dorsal advancement flap without skin graft for congenital syndactyly.J Hand Surg Am. 2015; 40: 1-7
- Congenital anomalies of the hand and forearm.in: 1st ed. Plastic Surgery. Vol. 8. WB Saunders, Philadelphia1990: 5280-5308
- Arterial anatomical basis of the dorsal digitometacarpal flap for long fingers.Surg Radiol Anat. 2008; 30: 429-435
- Syndactyly web space reconstruction using the tapered M-to-V flap: a single-surgeon, 30-year experience.J Hand Surg Am. 2015; 40: 1755-1763
- Aesthetic comparison of two different types of web-space reconstruction for finger syndactyly.Plast Reconstr Surg. 2018; 142: 963-971
Article info
Publication history
Published online: May 09, 2019
Accepted:
March 1,
2019
Received:
July 14,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
