scholarly journals Deviation and Atrophy of Middle Phalanx of Hand Following Partial Separation in Syndactyly Patient: Their Fault or Ours?

2021 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
Diana Murtiati Kusuma ◽  
Beta Subakti Nata'atmadja ◽  
Iswinarno Doso Saputro ◽  
Sitti Rizaliyana

Backgrounds: Syndactyly is failure of differentiation in which the fingers fail to separate into individual appendages. It is the most common congenital hand anomaly, with an incidence of 1 in 2,000 to 2,500 live births. Surgical separation of fingers as early as 6 month-old is indicated when syndactyly involves digits of unequal length (i.e., ring and little fingers). Early separation is also required in complex syndactyly and cases of acrosyndactyly. The timing of surgery of all other cases of syndactyly remains somewhat controversial; most suggest surgical correction before age of 18 months, whereas others prefer to wait until after this age.Case Presentation and Operation Technique: A 13-year old boy, presented with fusion of all fingers of the right hand at birth. Prior to his current visit, he underwent partial separation of the right fingers at the age of 6 y.o. at a local hospital. Following partial separation, the fingers did not grow normally. Current X-ray showed atrophy and deviation of middle phalanx. We performed separation of syndactyly between index and middle finger, and between fourth and small finger in our hospital. Interdigital webbings are released using local flap and the remaining raw surface is covered using full-thickness skin grafts. On follow up, the patient showed good functional and aesthetic outcome. He is able to write with his right hand with better coordination.Discussion: Complex syndactyly reconstruction is a challenging surgical problem. Common post surgical findings include rotational deformity, angular deformity, and nail deformity. We describe how we have altered our approach in these findings.Conclusion: Congenital syndactyly should be corrected early in life. Careful dissection, the use of a dorsal rectangular flap in combination with 2 volar triangular flaps, and use of full thickness skin grafts ensure a satisfactory outcome and minimize the number of operations per web

2005 ◽  
Vol 31 (12) ◽  
pp. 1707-1709 ◽  
Author(s):  
Amy R. Brackeen ◽  
Michael J. Wells ◽  
Jeff M. Freed

2012 ◽  
Vol 23 (4) ◽  
pp. 1196-1197
Author(s):  
Russell James Bramhall ◽  
Mark Gorman ◽  
Muhammad Adil Abbas Khan ◽  
Muhammad Riaz

1989 ◽  
Vol 15 (11) ◽  
pp. 1178-1183 ◽  
Author(s):  
MICHAEL J. MULVANEY ◽  
STUART J. SALASCHE ◽  
WILLIAM J. GRABSKI

1994 ◽  
Vol 102 (5) ◽  
pp. 781-788 ◽  
Author(s):  
John P Sundberg ◽  
Robert W Dunstan ◽  
Wesley G Beamer ◽  
Dennis R Roop

2021 ◽  
Vol 85 (3) ◽  
pp. AB110
Author(s):  
Joyce Chen ◽  
Nikita Gupta ◽  
Collin M. Costello ◽  
Carolyn Mead-Harvey ◽  
Katie L. Kunze ◽  
...  

2021 ◽  
Vol 47 (8) ◽  
pp. 1135-1137
Author(s):  
Frank W. de Jongh ◽  
Sjaak Pouwels ◽  
Christien Weenen ◽  
Willem A. van den Bosch ◽  
Dion Paridaens

2012 ◽  
Vol 25 (01) ◽  
pp. 42-48 ◽  
Author(s):  
S. C. Ralphs ◽  
G Coronado ◽  
D. C. Sweet ◽  
J. Ward ◽  
C. P. Bloch ◽  
...  

SummaryObjective: To compare the hydro-surgical technique to traditional techniques for removal of subcutaneous tissue in the preparation of full-thickness skin grafts.Study design: Ex vivo experimental study and a single clinical case report.Sample population: Four canine cadavers and a single clinical case.Methods: Four sections of skin were harvested from the lateral flank of recently euthanatized dogs. Traditional preparation methods used included both a blade or scissors technique, each of which were compared to the hydro-surgical technique individually. Preparation methods were compared based on length of time for removal of the subcutaneous tissue from the graft, histologic grading, and measurable thickness as compared to an untreated sample.Results: The hydro-surgical technique had the shortest skin graft preparation time as compared to traditional techniques (p = 0.002). There was no significant difference in the histological grading or measurable subcutaneous thickness between skin specimens.Clinical significance: The hydro-surgical technique provides a rapid, effective debridement of subcutaneous tissue in the preparation of full-thickness skin grafts. There were not any significant changes in histological grade and subcutaneous tissue remaining among all treatment types. Additionally the hydro-surgical technique was successfully used to prepare a full-thickness meshed free skin graft in the reconstruction of a traumatic medial tarsal wound in a dog.Presented at the ACVS symposium during the resident seminar, Seattle, Washington,USA on October 22, 2010.


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