Syndactyly release without using skin grafts

Abstract EN

Objectives : Syndactyly is one of the most common congenital hand deformities.

Web space reconstruction is an important component of syndactyly treatment.

Our objective is to evaluate the method of web space defect closure in syndactyly repair, using a V-Y dorsal metacarpal advancement flap, without using skin grafts.

Methods : Over the period of six years (May 2003 through May 2009), a total of 20 patients (24 hands, 25 web spaces) with simple syndactyly were operated upon using a dorsal metacarpal skin flap based on a direct coetaneous branch of the dorsal metacarpal artery.

This flap was advanced in a V-Y fashion to aid in web space defect closure, without using skin grafts.

There were 15 males and five females.

Four cases had bilateral, three had right sided and the remaining 13 had left sided syndactyly.

Fourteen cases had complete type and six had incomplete type.

The mean age at operation was 4.7 years (range 1-12).

The web spaces affected were the thumb-index, middle-ring, ring-little in one, 18, and six web spaces respectively.

The mean follow up period was 10 months (range 6-35 months).

Results : All patients had uneventful postoperative period.

There was no flap necrosis or digital vascular compromise.

One case showed hypertrophic scarring of the repair but all patients had acceptable range of motion at follow up.

Conclusion : Dorsal metacarpal skin flap advancement is a good way of repairing the web space defect during syndactyly release, eliminating the need for skin grafts.