title: Syndactyly Web Space Reconstruction Using the Tapered M-to-V Flap: A Single-Surgeon, 30-Year Experience.
abstract: OBJECTIVE
  To describe the technique and results of the tapered M-to-V flap for syndactyly web space construction.
  
  
  METHODS
  We reviewed a single-surgeon, single-institution experience of all syndactyly reconstructions performed between 1982 and 2013. Demographic data and patient characteristics were recorded. Complications included flap loss, graft loss, web creep, infection, restricted range of motion, and digit deviation.
  
  
  RESULTS
  A total of 138 web spaces were reconstructed in 93 patients. There were 89 primary congenital hand and 32 foot syndactylies. Four patients had an acquired simple incomplete syndactyly and 13 patients had secondary reconstructions. The complication rate was 14%. The most common complication was web creep resulting from partial skin graft loss (12 web spaces; 9%). There were no total flap losses. Univariate analysis revealed no factor to be predictive of an elevated complication rate. Average follow-up was 2.6 years (range, 6 mo to 26 y).
  
  
  CONCLUSIONS
  The tapered M-to-V flap proved to be a reliable and versatile technique for web space reconstruction, offering several advantages over the standard rectangular flap method of repair, such as ease of intraoperative adjustment, a z-plasty at the palmodigital crease to minimize scar contracture, and better color match.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Mericli
authors.affiliation: Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Black
authors.affiliation: Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA. Electronic address: rfm9u@virginia.edu.
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000002:abnormalities*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013576:Syndactyly / Q000601:surgery*; D014034:Toes / Q000002:abnormalities*; D016896:Treatment Outcome
keywords: M-to-V flap; Syndactyly; web space