Application of modified pentagonal dorsal finger flap in the congenital syndactyly release

Abstract

Objective To explore the clinical efficacy of modified pentagonal dorsal finger flap in the congenital syndactyly release. Methods From January 2010 to January 2014, 20 cases of simple cutaneous syndactyly were treated by modified pentagonal dorsal finger flap combined with finger Zigzag flap. The flap coverage scope, the occurrence of infection and necrosis of the skin flap and other early complications were recorded. The web depth and finger extension angle were measured and compared with the healthy side. Finger web creep and finger web scar were scored, and whether reoperation was performed due to the above complications was recorded. Questionnaire was used to evaluate parents' satisfaction. Results Twenty patients were follow-up for 30 to 75 months, with an average of 38 months. No complications such as infection and necrosis of skin flaps occurred after operation. The shape of the web was wide. The web depth of the affected side was (2.37±0.56) cm, and the finger extension angle was (24.50±4.74)°. There was no significant difference between the affected and healthy side. The reoperation rate due to web creep, web contracture and scar flexion contracture was 0. Family members were satisfied with the treatment outcome. Conclusion The modified pentagonal dorsal finger flap combined with finger Zigzag flap can reconstruct web space to the level of proximal interphalangeal joint, reduce the complications such as web creep and scar contracture after operation. Wide web is good for fingers to grasp large objects with high operative safety. Key words: Hand deformities,congenital; Syndactyly; Modified pentagonal dorsal finger flap; Web reconstruction; Web contracture