Syndactyly Correction without Skin-Grafting

Abstract

Syndactyly correction results in skin deficiency. Skin grafting is avoided by the use of an extended dorsal interdigital flap for the web and approximation of the side flaps to cover the length of the digits. The technique has been used in 17 cases with all varieties of syndactyly. There were no early complications. The follow-up averaged 2 years. There were two cases of web creep but no contractures. The method combines the advantage of direct suture with an acceptable frequency of web creep.

The Use of an Hourglass Dorsal Advancement Flap Without Skin Graft for Congenital Syndactyly

“…Defatting of the fingers and the interdigital space was performed to facilitate closure without skin graft, which may reduce recurrence and web creep. 7,9,10,16,18 Although defatting may lead to a thin finger, we observed no conspicuous change in finger contour compared with the non-syndactylized fingers in our cases. This may be because of the early separation age and good tissue regeneration capacity in children.…”

“…Ekerot 16 reported a technique using a dorsal flap from the syndactylized proximal phalanges to substitute commissural skin grafts. After that, a variety of dorsal flaps have been described to repair syndactyly without skin grafts.…”

Long-Term Outcomes of Web Creep, Scar Quality, and Function After Simple Syndactyly Surgical Treatment

“…10 -13 Withey et al and Deunk et al introduced a scoring system for its quantification after surgical release of syndactyly. 14,15 The evaluation of a surgical scar after syndactyly release has received less attention 10,11 or was based on 3-point scales evaluating only few aspects of a scar. 14,15 The Vancouver Scar Scale (VSS), which was initially established for burn wounds, 16,17 is an established instrument for scar evaluation.…”

Evolution of surgical techniques for skin releases in the treatment of simple congenital syndactyly: a review

“…3d). During the last decade a new generation of flaps has been developed to decrease the need for skin grafting [6,14,15,34,43]. These flaps are usually larger and more proximally-raised than conventional triangular or rectangular flaps and allow for closure without skin grafts.…”

“…4f). Ekerot used this flap in a larger series and compared Niranjan's technique with the traditional skin-grafting procedure [14,15]. Decreased operating time and fewer complications were found in the non-grafted group [15].…”