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Arch Hand Microsurg > Volume 24(2); 2019 > Article
Archives of Hand and Microsurgery 2019;24(2):189-196.
Published online June 1, 2019.
DOI: https://doi.org/10.12790/ahm.2019.24.2.189   
Dorsal Bilobed Rectangular Flap and Volar Triangular Flap with Back-Cuts in the Correction of Hand Syndactyly
Suk Joon Oh
Department of Burn and Reconstructive Surgery, Bestian Seoul Hospital, Seoul, Korea. sjoh46@nate.com
Received: 3 December 2018   • Revised: 11 March 2019   • Accepted: 4 April 2019
Abstract
Purpose
Syndactyly is a one of the most common congenital anomalies of the hand. Each patient requires a thorough assessment of the soft-tissue and bony components within the syndactylized region. The aim of this article is to describe the exact design of the surgical procedure to prevent postoperative web creep using two volar back-cuts in syndactyly correction.

Methods
A retrospective data review of a series of twenty-two consecutive patients who were treated with correction of congenital syndactyly of the hand was conducted. Total patients number was 22. Web separation was performed in 44 webs among a total of 55 webs. This surgical technique was inserting small bilobed rectangular flaps into the volar back-cut defects on both sides, and longer dorsal rectangular flap than the previous surgical technique. Follow-up patients assessed the occurrence of patients that required secondary surgery due to web creep and patients of other sequels.

Results
Total separations of syndactyly of 22 patients who were corrected primarily (40 webs) and secondarily (4 webs) after treatment at other hospitals. There was no postoperative web creep during follow-up. Sequels with different color matches of full-thickness skin graft, angulations (3 patients), and ankylosis (1 patient) were due to the underlying bone and joint structure. Vascular and nerve injuries were absent.

Conclusion
Reconstructing a hand with syndactyly can be complicated and is fraught with potential pitfalls. Careful planning and meticulous surgical techniques with this surgical technique can minimize potential errors and allow satisfactory separation of syndactylized digits.
Key Words: Hand, Syndactyly, Congenital anomaly
 
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