Improved "bell-bottom" flap surgical technique for syndactyly without skin graft.
BACKGROUND
This study describes the use of a modified "bell-bottom" flap for treatment of partial syndactyly release that may avoid the use of skin grafting.


METHODS
A retrospective review of this procedure was performed for 12 interdigital space reconstructions. Patients were aged 1 to 5 years 6 months. The mean follow-up period was 24 months. The operations were performed to avoid skin grafting. The flap was designed in the narrow-spaced and fused interdigital region of syndactyly for preventing postoperative scar contracture and web formation.


RESULTS
Surgery was completed without skin grafting in all cases. The use of a modified flap allowed the construction of interdigital spaces with sufficient width, providing satisfactory cosmetic outcomes. No partial necrosis or complications were observed. No web formation, elevation of the interdigital space, or limited range of joint motion caused by contracture was observed during the 2-year follow-up period, and no secondary correction was needed.


CONCLUSIONS
The present surgical technique may be a new surgical option for web release in which fingers are fused at a level lower than the midpoint between the proximal and distal interphalangeal joints.


METHODS
Therapeutic, V.
Chiba, Tokyo, and Kagosima, Japan From the Department of Plastic Surgery, Yachiyo Medical Center, Tokyo Women's Medical University; the Institute of Advanced Biomedical Engineering and Science and the Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University; and the Department of Plastic and Reconstructive Surgery, Kagoshima City Hospital.
Hajime
H
Matsumine
Yuichiro
Y
Yoshinaga
Osamu
O
Fujiwara
Ryo
R
Sasaki
Masaki
M
Takeuchi
Hiroyuki
H
Sakurai
D002675:Child, Preschool; D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D003286:Contracture / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation; D013524:Surgical Flaps; D013576:Syndactyly / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome