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2008 Annual Meeting Abstracts

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The Modified V-Y Dorsal Metacarpal Flap for Repair of Syndactyly Without Skin Graft: Fifty Consecutive Cases
Vivian M. Hsu, BA, James M. Smartt, Jr., MD, Benjamin Chang, MD.
Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

PURPOSE: Syndactyly repairs that utilize full thickness skin grafts (FTSGs) are sometimes associated with skin graft-related complications. This study reviews our experience with the modified dorsal V-Y advancement flap, which allows for syndactyly release that often eliminates the need for FTSGs.
METHODS: A retrospective case series of all patients undergoing syndactyly release without skin grafting by the senior author between 1998 and 2007 was performed. All outpatient and inpatient charts were reviewed for pertinent patient demographics and clinical outcomes, including the incidence of web creep, hypertrophic scarring, flexion contracture, infection, angulation deformity, limited range of motion, ischemia, and need for reoperation. The complication rates of patients who underwent release of simple syndactyly were quantified.
RESULTS: A total of 50 syndactylys were included in the study: 42 simple incomplete and 8 simple complete. Mean duration of follow-up was 2.6 years, with a range of 1 month to 8.5 years. Two patients experienced postoperative complications, with one incidence of angulation deformity and one incidence of web creep, for a total complication frequency of 4.3% among simple syndactyly repairs.
CONCLUSION: The modified dorsal V-Y advancement flap is an effective method of surgical release in simple complete and incomplete syndactyly.


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