Dorsal Hexagon Local Flap Without Skin Graft for Web Reconstruction of Congenital Syndactyly

Wang, Sisheng; Zheng, Shaoluan; Li, Nanzhu; Feng, Zihao; Liu, Qi

doi:10.1016/j.jhsa.2019.03.009

Cited by 10 publications

(13 citation statements)

References 13 publications

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“… 27 , 28 , 31 It has, however, been suggested that zigzag incisions and skin grafts lead to conspicuous scars. 35 The risk of scar contractures (0%–6%) or hypertrophy seem to be lower with graftless techniques, 7 , 8 , 10 , 16 which is in accordance to our findings so far with no scar contractures and 2/30 hypertrophic scars that responded well to silicone treatment.…”

Section: Discussionsupporting

confidence: 92%

“… 25 The reported length of simple syndactyly separation without skin grafts with metacarpal advancement flaps and zigzag incisions is shorter ranging between 44 and 86 minutes. 8 , 16 , 26 In our series, separation of SI syndactyly lasted for just over an hour, in most SC and CC syndactylies, it lasted for <2 hours and in C syndactyly, slightly longer, which is quite close to the reported operation times with other graftless techniques.…”

Section: Discussionsupporting

confidence: 87%

“…Sharma et al 11 separated 14 fingers in 7 patients (2 syndromic) using longitudinal incisions and a triangular metacarpal advancement flap with functionally and esthetically pleasing results, but they failed to report the level of separated webs in nonsyndromic hands. Wang et al 16 have recently reported a series of 16 web reconstructions using a hexagonal metacarpal advancement flap with zigzag incisions, yielding satisfactory results in 12- to 34-month FU. We used the same technique since 2003 but developed it further to straight incisions that leave the scars in the mid-lateral line in combination with the hexagonal metacarpal advancement flap to reconstruct the web.…”

Section: Discussionmentioning

confidence: 99%

“…These techniques most commonly utilize a zigzag incision for finger separation with different types of metacarpal advancement flaps to reconstruct the web. 8 – 16 …”

Section: Introductionmentioning

confidence: 99%

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New Simple Technique for Syndactyly Release

Grahn

Nietosvaara

Sommarhem

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Can good functional and cosmetic result be achieved in syndactyly separation using a straight midline incision with a hexagonal dorsal skin flap? Methods: We performed 39 web reconstructions at a median of 20 months of age (11–43 months) to 26 consecutive children (21 male) with 30 simple, 4 complex, and 5 complicated syndactylies. Eighteen of the simple syndactylies were incomplete, ending at the proximal interphalangeal joint in 15 and at the distal interphalangeal joint in 3. Inguinal skin grafts were used in 2 children with either complex or complicated syndactyly. Operation time was recorded. Complications were registered. Height of the new web spaces was calculated. Parents’ satisfaction on both functional and cosmetic outcome was assessed using a Visual Analog Scale from 0 to 100. Results: Duration of one web reconstruction ranged from 50 to 95 minutes in simple incomplete, 56 to 135 in simple complete, 116 to 151 in complex, and 72 to 123 in complicated syndactylies. One child had a self-induced bilateral postoperative infection that lead to web creep. Two patients developed hypertrophic scars, which responded well to silicone treatment. Mean cosmetic and functional Visual Analog Scale scores were 87 (45–100) and 92 (63–100), respectively, at a mean follow-up of 1.3 years (range, 0.5–3.7). Conclusion: Web reconstruction using a hexagonal dorsal skin flap and straight midline incisions with closure at mid-lateral lines is safe, with good cosmetic and functional outcome in our short-term follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…These techniques most commonly utilize a zigzag incision for finger separation with different types of metacarpal advancement flaps to reconstruct the web. 8 – 16 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

New Simple Technique for Syndactyly Release

Grahn

Nietosvaara

Sommarhem

et al. 2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…7). Similarly, numerous shapes have been proposed, such as pentagonal [44,45], hexagonal [46,47], bilobed [48], trilobed [20,49,50], quadrilobed [51,52], and gullwing-shaped flaps [53,54].…”

Section: Interdigital Commissurementioning

confidence: 99%