title: Dorsal plane-shaped advancement flap for the reconstruction of web space in syndactyly without skin grafting: A preliminary report.
abstract: BACKGROUND
  Skin grafting for syndactyly repair is time-consuming, and it has the potential risks of scar contracture and web creep. Several techniques have been described for web reconstruction without skin grafts in simple syndactyly. Based on the hexagonal advancement flap, we designed a "plane-shaped" advancement flap on the dorsal hand or foot for a web reconstruction with primary closure.
  
  
  METHODS
  Between June 2010 and August 2013, a "plane-shaped" advancement flap was used for web reconstruction in 24 syndactylies of 20 pediatric patients. The patients' age ranged from 1.5 to 8 years (mean age: 2.5 years). The patients were followed up for 15-48 months (mean: 28 months).
  
  
  RESULTS
  The mean operation time was 60 min (range: 50-75 min). All incisions were closed primarily without skin grafting. All the flaps survived completely without early complications such as infection, vascular compromise or delayed healing. The mean hospitalization time was 3.5 days. There was no occurrence of long-term complications including web creep, flexion contractures, angulation deformity, or obvious keloid formation during the 15-48 months follow-up. Cosmetic and functional satisfactory outcomes were achieved in all cases without secondary revision.
  
  
  CONCLUSIONS
  The dorsal plane-shaped advancement flap without skin graft is a solution for web space reconstruction in simple syndactyly, especially in the foot.
authors.affiliation: Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: liujuan_1018@126.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: zhenghuaiyuan@126.com.
authors.forename: Huaiyuan
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
authors.forename: Zhenbing
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Xinyi
authors.initials: X
authors.lastname: Dai
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Arndt F
authors.initials: AF
authors.lastname: Schilling
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Hans-Günther
authors.initials: HG
authors.lastname: Machens
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000002:abnormalities* / Q000601:surgery; D005500:Follow-Up Studies; D005528:Foot / Q000601:surgery; D006225:Hand / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps; D013576:Syndactyly / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Flap; Surgery; Syndactyly; Web space