Reconstruction of the first web space in symbrachydactyly using the reverse radial forearm flap.
OBJECTIVE
To present a new approach for the reconstruction of severe first web contractures using a distally based reverse radial forearm flap in symbrachydactyly patients.


METHODS
This study included 6 hands in 5 patients. Subjective evaluation included appearance, parent satisfaction (and patient satisfaction when appropriate), and ability to perform daily activities such as thumb-index grasp and pinch at follow-up evaluations. We measured the angle between the first and second rays using a goniometer at maximum radial abduction, and pinch and grasp strengths were evaluated as an objective assessment.


RESULTS
The average follow-up period was 2 years. All parents and patients were happy with the aesthetic appearance. They were completely satisfied in their daily living activities. The average first web angle measurement was 56 degrees . An average of 39 degrees of improvement of web measurement was achieved. For the unilateral 4 patients, the average pinch strength measurement was 80% of the normal contralateral hand and the grip strength was 75% of the normal contralateral hand.


CONCLUSIONS
The reverse radial forearm flap was found to be a safe and simple method in the reconstruction of severe first web contractures in symbrachydactyly patients. This method provided good coverage of appropriate thickness and skin quality, and supple soft tissue that filled the first web space.


METHODS
Therapeutic IV.
Gülgönen
Ayan
A
Department of Hand and Microsurgery, VKV American Hospital, Nisantasi, Istanbul, Turkey. drayangulgonen@hotmail.com
Güdemez
Eftal
E
D000203:Activities of Daily Living; D002675:Child, Preschool; D004954:Esthetics; D005260:Female; D005385:Fingers / Q000002:abnormalities* / Q000601:surgery*; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D017060:Patient Satisfaction; D013524:Surgical Flaps; D013576:Syndactyly / Q000601:surgery*