Application of the great toe fibular island flap for syndactyly separating of 1st & 2nd and 2nd & 3rd toes
Xu Wenpeng, Wang Yang, Zhang Ning, Cao Songhua, Hu Yong
Department of Hand & Foot Surgery, the Second Hospital of Shandong University, Foot & Ankle Surgery Center of Shandong University, Ji'nan 250033, China
Abstract:Objective To investigate the application of the great toe fibular island flap for syndactyly separating.Methods A retrospective analysis of 24 patients with toe deformity from June 2014 to June 2017 was performed. There were 14 boys and 10 girls, the age ranged from 6 to 47 months(median 29.2 months). There were 8 cases involved first & second toes, 16 cases involved second & third toes. The great toe fibular island flap was used for repairing skin defect of web during separating syndaetyly without skin grafting.Results All cases were corrected successfully with deep toe-webs and natural expansion between toes. Twenty-two patients were followed up for 3 to 36 months, with an average of 8.2 months. 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 without abnormal sensation. The toe fuction was good and similar to the healthy side, without serious complications.Conclusions The great toe fibular island flap may repair left skin defect in separating syndactyly of the first & second toes and the second & third toes without skin grafting. The flap is reliable, safe and efficient for syndactyly separating.
徐文鹏,汪洋,张宁,曹松华,胡勇. 𧿹趾腓侧皮瓣在1、2趾和2、3趾并趾分趾术中的应用[J]. 中华解剖与临床杂志, 2019, 24(2): 129-132.
Xu Wenpeng, Wang Yang, Zhang Ning, Cao Songhua, Hu Yong. Application of the great toe fibular island flap for syndactyly separating of 1st & 2nd and 2nd & 3rd toes. Chinese Journal of Anatomy and Clinics, 2019, 24(2): 129-132.
McDaniel L, Tafuri SA. Congenital digital deformities[J]. Clin Podiatr Med Surg, 1996, 13(2): 327-342.
[2]
Hayashi A, Yanai A, Komuro Y, et al. A new surgical technique for polysyndactyly of the toes without skin graft[J]. Plast Reconstr Surg, 2004, 114(2): 433-438. DOI:10.1097/01.PRS.0000131882.19567.65.
[3]
Miyanaga T, Shimada K, Kishibe M, et al. The double volar flap technique for aesthetic repair of syndactyly and polysyndactyly of toe without skin grafting[J]. Plast Reconstr Surg Glob Open, 2017, 5(4): e1293. DOI:10.1097/GOX.0000000000001293.
[4]
Lim YJ, Teoh LC, Lee EH. Reconstruction of syndactyly and polysyndactyly of the toes with a dorsal pentagonal island flap: a technique that allows primary skin closure without the use of skin grafting[J]. J Foot Ankle Surg, 2007, 46(2): 86-92. DOI:10.1053/j.jfas.2006.11.008.
Park S, Eguchi T, Tokioka K, et al. Reconstruction of incomplete syndactyly of the toes using both dorsal and plantar flaps[J]. Plast Reconstr Surg, 1996, 98(3): 534-537.
Itoh Y, Arai K. A new operation for syndactyly and polysyndactyly of the foot without skin grafts[J]. Br J Plast Surg, 1995, 48(5): 306-311. DOI:10.1016/0007-1226(95)90069-1.
[9]
Coleman WB, Kissel CG, Sterling HD Jr. Syndactylism and its surgical repair[J]. J Am Podiatr Med Assoc, 1981, 71(10): 545-550. DOI:10.7547/87507315-71-10-545.
Kawabata H, Ariga K, Shibata T, et al. Open treatment of syndactyly of the foot[J]. Scand J Plast Reconstr Surg Hand Surg, 2003, 37(3): 150-154. DOI:10.1080/02844310310007755.
[12]
Sakamoto N, Matsumura H, Komiya T, et al. Syndactyly correction using a venous flap with the plantar cutaneous venous arch[J]. Ann Plast Surg, 2014, 72(6): 643-648. DOI:10.1097/SAP.0b013e31826a1d1d.
[13]
Onishi K, Nakajima T, Yoneda K, et al. Operation for polysyndactyly of the fifth toe using Z-plasty[J]. Br J Plast Surg, 1992, 45(7): 554-556. DOI:10.1016/0007-1226(92)90155-Q.
[14]
Hirshowitz B, Karev A, Rousso M. Combined double Z-plasty and Y-V advancement for thumb web contracture[J]. Hand, 1975, 7(3): 291-293. DOI:10.1016/0072-968X(75)90071-6.
[15]
Ostrowski DM, Feagin CA, Gould JS. A three-flap web-plasty for release of short congenital syndactyly and dorsal adduction contracture[J]. J Hand Surg Am, 1991, 16(4): 634-641. DOI: 10.1016/0363-5023(91)90186-F.
[16]
Sherif MM. V-Y dorsal metacarpal flap: a new technique for the correction of syndactyly without skin graft[J]. Plast Reconstr Surg, 1998, 101(7): 1861-1866.
[17]
Saito S, Suzuki Y, Suzuki S. Technique of dorsal transversely oriented transposition flap for web reconstruction in toe syndactyly surgery[J]. J Foot Ankle Surg, 2015, 54(6): 1119-1123. DOI:10.1053/j.jfas.2015.03.003.
[18]
Hikosaka M, Ogata H, Nakajima T, et al. Advantages of open treatment for syndactyly of the foot: Defining its indications[J]. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(3): 148-152. DOI:10.1080/02844310802556968.