Open Treatment of Syndactyly of the Foot

Abstract

The aim of reconstruction of the webs for syndactyly of the foot is cosmetic improvement, so skin grafting should be avoided. We present our long-term results of 19 feet with simple cutaneous syndactyly in 15 patients who were treated by an open technique. The bottom of the web was covered with a dorsal rectangular flap and the remaining skin defect was left open to epithelialise spontaneously. This took about 4 weeks. After a mean follow-up of 5.7 years (range 3-9), no hypertrophic scar or pigmentation of the skin had developed. Creeping of the web was seen only during the first postoperative year. The final depth of the web satisfied the families of all patients. As the aim of web reconstruction for syndactyly of the foot is purely cosmetic, we conclude that this simple method is reasonable treatment.

Advantages of open treatment for syndactyly of the foot: Defining its indications

“…However, there have been only a few reports about its use in repair of syndactyly [2,3]. Both these reports show good results, with the former (syndactyly of the hand) reporting better scar quality with the open treatment than with grafting, and the latter (syndactyly of the foot) reporting no hypertrophic scarring and better colour match with the open treatment.…”

“…Open treatment is a technique in which the raw surface is left open to epithelialise, and it is commonly used in the treatment of Dupuytren contracture [1]. Several reports about the open treatment in repair of syndactyly have been published in the past, both in the hand and the foot [2,3]. Our purpose was to clarify the process of epithelialisation and to define the indication for open treatment in repair of syndactyly of the foot.…”

The Double Volar Flap Technique for Aesthetic Repair of Syndactyly and Polysyndactyly of Toe without Skin Grafting

“…All techniques used local flaps to create web slope; however, there are differences in the treatment of skin defects in the lateral aspects of the toes. 3–10 The techniques may be divided according to the treatment of skin defects in the lateral aspects of the toes into 3 groups: skin grafts, open treatment, and local flaps.…”

“…However, problems associated with the use of skin grafts include contractures and hypertrophic scars in the case of partial graft loss, pigmentation differences between the donor and recipient sites, suboptimal digital contour, donor-site morbidity, and a time-consuming repair. 3,4 …”

Foot Syndactyly: A Clinical and Demographic Analysis

“…Recently, various techniques that do not require the application of skin grafts, such as open treatment, primary closure by defatting [78], or intricate local flaps [910], have been reported. These techniques are advantageous in that they shorten the operation time and minimize donor site morbidity.…”