Web reconstruction with dorsal metacarpal rhombus advancement flap in the treatment of syndactyly

Abstract

Objective To report the clinical outcomes of reconstructing the web with dorsal metacarpal rhombus advancement flap in the treatment of syndactyly. Methods Five children with syndactyly were operated. After the digits were divided, a dorsal rhombus flap was designed between the metacarpal heads and advanced to reconstruct the web space. The following aspects were evaluated during postoperaive follow-up:finger function, web space and appearance, and patients' satisfaction. Results The area of flaps ranged from 1.5 cm× 0.6 cm to 2.0 cm× 0.9 cm. All the flaps healed primarily without flap congestion and marginal necrosis. The patients were follow-up for 6 to 12 months with an average of 8.5 months. Finger flexion and extension was good. The contour of the web was satisfactory with appropriate width and depth. The patients' parents were satisfied with both finger function and web appearance. Conclusion Dorsal metacarpal rhombus advancement flap is a reliable flap with easy dissection and good texture for web reconstruction in syndactyly surgery. Key words: Hand deformities,congenital; Syndactyly; Surgical flaps