Aesthetic outcomes following adipose flap versus fillet flap technique for radial polydactyly: a comparison study

Abstract

We performed a comparative study looking at the aesthetic outcomes of using a digital artery vascularized adipose flap (DAAF) for treatment of Wassel type IV radial polydactyly versus a fillet flap technique. Clinical charts and pictures of patients between 2002 and 2017 were reviewed to evaluate the appearance of 16 reconstructed thumbs using a visual analogue scale. Our results showed that the DAAF technique resulted in better outcomes with regard to contour of the thumb than the fillet flap group, with significantly less conspicuous scarring in the DAAF group. We conclude that the DAAF can produce better aesthetic outcomes in the reconstruction of radial polydactyly than conventional fillet flaps. Level of evidence: III

Recent Advancements in the Diagnosis and Treatment of Congenital Hand Differences

“…However, there are discernible scars present from the dorsal and volar zigzag incisions. 11 Tsunekawa et al 11 sought to improve upon this technique by introducing their digital artery-vascularized adipose flap that uses a radial longitudinal incision at the MCP joint, along the glabrous/nonglabrous junction. Visual analog scale (VAS) scores were markedly higher in the digital artery-vascularized adipose flap group versus the fillet flap group, but no differences in contour were found between groups.…”

“…Visual analog scale (VAS) scores were markedly higher in the digital artery-vascularized adipose flap group versus the fillet flap group, but no differences in contour were found between groups. 11 Depending on the level of duplication, another area of postoperative concern for the preserved thumb is poor joint stability, abduction function, and bony alignment. 12,13 For Wassel-Flatt types III and VII, Zhou et al 12 introduced an absorbable anchor technique, consisting of a tiny implant fixed in bone, to allow the soft tissues (articular capsule, collateral ligament, abductor pollicis brevis, flexor pollicis brevis) to be anchored to the implant instead of the periosteum.…”

“…Visual analog scale (VAS) scores were markedly higher in the digital artery–vascularized adipose flap group versus the fillet flap group, but no differences in contour were found between groups. 11…”