Application of metatarsal artery flap for repairing polysyndactyly and syndactyly of toes

Abstract

Objective To design a pedicled island flap with metatarsal artery for repairing skin defect after separating polysyndactyly and syndactyly. Methods Among 49 cases, 28 of them were followed up from January 2010 to January 2013.There were polysyndactyly (n=7) and syndactyly (n=21). And the latter involved first & second toes (n=5), second & third toes (n=3), third & fourth toes (n=4) and fourth & fifth toes (n=9). Pedicled island flap with metatarsal artery was used for repairing skin defect after separating polysyndactyly and syndactyly without skin grafts. Results All cases were corrected successfully with deep toe-webs and natural expansion between toes.During a median follow up period of 8 months, excellent appearance and texture appeared without local pain.The color of flap was similar to that of adjacent skin.And static two-point discrimination was 4 to 10 mm. Conclusions Pedicled island flap with metatarsal artery may repair left skin defect fully after separating polysyndactyly and syndactyly without skin grafting.And donor site may be readily sutured.Thus metatarsal artery flap transplantation is reliable, safe and efficient for repairing polysyndactyly and syndactyly of toes. Key words: Polysyndactyly; Syndactyly; Congenital malformation; Skin flap grafting