Technical Modification in Repair of Syndactylism

Bauer, Thomas B.; Tondra, John M.; Trusler, Harold M.

doi:10.1097/00006534-195605000-00007

Cited by 82 publications

(27 citation statements)

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“…Many techniques have been described for correction of syndactyly [9,12]. Most are based on either triangular flaps [2,4,5,7,16,17], or dorsal quadrilateral flaps [1,6,8,10,13,14]. Normal web skin is dorsal in origin, inclined distally at 40 °; the dorsal quadrilateral flap technique should therefore provide a more anatomically correct repair and natural appearance [12,16].…”

Section: Discussionmentioning

confidence: 99%

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Web creep: the role of infection and delayed healing

1992

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Eur J Plast Surg (1992) 15:69-71 European 'lr~l ,L Q ,'c~urnal el ElaStiC Summary. Twenty-five digital webs from 21 patients,where web "creep" was noted after division of simple syndactyly were reviewed. In all cases web creep was related to delayed healing and the average time to its appearance was 8 months.Web creep is a well-known complication of syndactyly release. Although it is taught that it occurs slowly with growth, a literature search revealed no mention of the timing of occurrence [4-6, 9, 16]. It was our impression that web creep appeared soon after treatment, and a retrospective review was performed to investigate when the phenomenon was first noted and any possible association with the design of flaps, types of grafts, delayed healing or infection. ResultsThe case records of 79 unselected children with syndactyly were studied. Twenty-five webs in 21 children were found to have web creep following release of their simple syndactyly. Sixteen were males and 5 females. Their average age at primary surgery was 4.4 years (range 2-8 years) (Fig. 1). The right hand was involved in 15 cases and the left in 10. The third web was most commonly involved. Dorsal quadrilateral and opposed triangular flaps were used to cover the web in equal numbers. In 2 cases the flap used was not recorded. Split skin grafts were used in 15 webs and full thickness grafts were used in 10. Partial graft take was noted in 17 webs of which 10 were split skin and seven full thickness grafts. The remaining 8 webs were clinically infected with discharging wounds. Bacteriology swabs were taken from 13 webs. Staphylococcus aureus was isolated from 9 webs together with

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Section: Discussionmentioning

confidence: 99%

“…Boyes [2], argued that there was a better colour match with split skin grafts. Advocates of full thickness grafts hold the opposite view and state that less contraction occurs [1,4,9,14,17].…”

Section: Discussionmentioning

confidence: 99%

Web creep: the role of infection and delayed healing

1992

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“…Many techniques have been described for web reconstruction in syndactyly release. One of the commonest is the use of interdigitating triangular skin flaps from the dorsal and volar digital surfaces (Bauer et al, 1956;Cronin, 1956). Straight scars along the web base must be avoided to prevent web creep, where scar tissue grows to recreate the syndactyly.…”

Section: Syndactylymentioning

confidence: 99%

Textbook of Plastic and Reconstructive Surgery

Butler¹,

Ghali²,

Kalaskar³

2016

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A CIP catalogue record for this book is available from The British Library.This book is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. The user is advised to always check the product information and clinical procedures with the most up-to-date published product information and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or misuse or misapplication of material in this work.ISBN: 978-1-910634-37-0 (Hbk.) ISBN: 978-1-910634-38-7 (Pbk.) ISBN: 978-1-910634-39-4 (PDF) ISBN: 978-1-910634-40-0 (epub) ISBN: 978-1-910634-41-7 (mobi)

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“…The plastic surgeon should understand the functionality of the hand to correctly treat the syndactyly [2][3][4] . There are many reported treatments for this sequel with various features and behaviors [5][6][7][8] . We have adopted a systematic technique at our institution that optimizes results and improves the function of the hand.…”

Section: Introductionmentioning

confidence: 99%

Sindactilia pós-queimadura da mão

Ribeiro¹,

Morais²,

FACHINELLI³

2013

Rev. Bras. Cir. Plást.

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Introduction: Syndactyly caused by burns to the hand is a severe and disabling sequel that limits hand function. In most cases, it results from poor scar orientation during the acute phase of the burn. This article describes the systematic technique adopted by our institution to treat this sequel, and establishes normal parameters to be investigated and surgical techniques. Methods: Between January 2009 and December 2012, 150 patients with syndactyly caused by burns to the hand underwent reconstructive surgery. The following 4 surgical steps were used to treat all patients: preparation of the dorsal flap; syndactyly release; migration and suturing of the flap to its new position; and skin graft to fill the remaining spaces. Results: There was graft survival in 100% of cases. Partial graft loss occurred 20 cases, and there were no cases of local infection. All patients recovered their hand function, including the ability to hold, and digital abduction. Conclusions: Syndactyly after burns is extremely limiting to the patient. The use of basic techniques of flaps and grafts results in successful treatment, restoring hand function compromised by the injury.Keywords: Burns/complications. Burns/rehabilitation. Hand. Syndactyly/surgery. RESUMO Introdução:A sindactilia por queimadura é uma sequela grave e incapacitante, e limita a função preensora da mão. Na maioria dos casos, é decorrente de má orientação cicatricial na fase aguda da queimadura. O objetivo deste artigo é descrever sistematização técnica adotada em nossa instituição, estabelecendo parâmetros de normalidade a serem buscados e técnicas cirúrgicas que auxiliem no tratamento. Método: No período de janeiro de 2009 a dezembro de 2012, 150 pacientes portadores de sindactilia decorrente de queimadura da mão foram submetidos a cirurgia reparadora. Em todos os pacientes, foram adotadas 4 etapas cirúrgicas: confecção do retalho dorsal; liberação da sindactilia; migração e sutura do retalho dorsal para sua nova posição interdigital; enxertia dos gaps com pele total, preenchendo os espaços remanescentes. Resultados: Em 100% dos casos houve total sobrevivência dos retalhos, com perda parcial de enxerto em 20 pacientes e nenhum caso de infecção local. Em todos os pacientes dessa série foi observada recuperação da função da mão, com capacidade de preensão e de abdução digital restauradas. Conclusões: A sindactilia pós-queimadura é uma deformidade extremamente limitante ao paciente. O emprego de técnicas básicas de retalhos e enxertos proporcionou sucesso no tratamento, com restauração da função da mão, comprometida pela lesão.Descritores: Queimaduras/complicações. Queimaduras/reabilitação. Mãos. Sindactilia/ci rurgia.

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Technical Modification in Repair of Syndactylism

Cited by 82 publications

References 0 publications

Web creep: the role of infection and delayed healing

Web creep: the role of infection and delayed healing

Textbook of Plastic and Reconstructive Surgery

Sindactilia pós-queimadura da mão

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