Modified Z-plasty repair of webbed neck deformity seen in Turner and Klippel-Feil syndrome.
OBJECTIVE
Webbed neck deformity exists in many syndromes including Turner's or Klippel-Feil syndrome. Multiple problems are encountered with existing techniques to correct a webbed neck deformity. In Turner's syndrome, a subcutaneous band of thickened fascia and a low neck hairline present a challenge to the surgeon when designing a repair. The authors propose the following new technique that addresses both issues.


METHODS
Five patients with webbed neck underwent this new procedure. A Z-plasty is performed with the midline arm down the length of the web. The subcutaneous fibrous band is excised, the shortened trapezius is released, and the hair-bearing flap is excised. The anterior flap is rotated and advanced to join its mate flap from the contralateral neck at the posterior midline. A resultant dog-ear near the acromion is corrected with an additional Z-plasty.


RESULTS
In all five patients, the functional and aesthetic results were very satisfactory to both patient and surgeon. An 11-year follow-up is presented with excellent correction of the webbing. Both limited range of motion and the cosmetic deformity are addressed by this technique.


CONCLUSIONS
The results obtained by using the simplified modified Z-plasty technique for repair of webbed neck deformity are very satisfactory. We propose the use of this technique for correction of webbed neck deformities whenever the posterior surface of the neck web contains a significant amount of hair.
Hikade
Katie R
KR
Department of General Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Bitar
George J
GJ
Edgerton
Milton T
MT
Morgan
Raymond F
RF
D002574:Cervical Vertebrae / Q000503:physiopathology; D002675:Child, Preschool; D003286:Contracture / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D004954:Esthetics; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007714:Klippel-Feil Syndrome / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation; D009333:Neck / Q000002:abnormalities* / Q000601:surgery; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology; D013524:Surgical Flaps; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000601:surgery*