title: Long-term aesthetic outcome of fingertip reconstruction in complete syndactyly release.
abstract: An aesthetically pleasing fingertip is an important but often under evaluated goal in syndactyly release. We assessed the aesthetic fingertip outcome in 26 patients with complete syndactylies, with a total of 84 separated digits, using a four-grade scale based on the quality of the lateral nail fold, nail plate definition, symmetry and pulp fullness. Fingertips with complete simple syndactylies released with the use of full-thickness skin grafts achieved a significantly better aesthetic result then fingertips with complete complex syndactylies released with the use of Buck-Gramcko pulp flaps. Fingertips involved in complex syndactylies achieved significantly better aesthetic results when reconstructed using Buck-Gramcko flaps in comparison with those reconstructed with full-thickness skin grafts. We recommend the use of Buck-Gramcko flaps in complete complex syndactylies, while reserve the traditional zig-zag and full-thickness skin graft closure for cases of complete simple syndactylies. We also propose a grading system for the aesthetic outcome of the fingertip following syndactyly release.
authors.affiliation: Department of Plastic Surgery, University Hospital Zagreb, Zagreb, Croatia. kbulic@kbc-zagreb.hr
authors.forename: K
authors.initials: K
authors.lastname: Bulic
mesh_terms: D000168:Acrocephalosyndactylia / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D013576:Syndactyly / Q000601:surgery*; D016896:Treatment Outcome