Cerebral Palsy-Case: Syndactyly Case Example

Case: Syndactyly Case Example

Pdf Summary

The document discusses the technique for performing a dorsal flap with skin grafts in cases of complete syndactyly. Syndactyly refers to the condition where two or more digits are fused together. The technique involves creating a dorsal commissure flap and a palmar rectangular flap to resurface the adjacent areas of the fused digits. Buck-Gramcko flaps can also be used for lateral nail fold reconstruction. The technique starts with thin dorsal flaps that become thicker at the base, and sharp dissection is used to separate the digits. Care is taken to identify the bifurcation between the common and proper neurovascular structures. The separated digits are defatted before the flaps are inset and closed. Remaining gaps are closed with full-thickness skin grafts, and the dorsal and volar appearances after closure are assessed. Post-op care includes minimizing shear and hematoma by using Adaptik maltese cross and fluffs between fingers, and protecting the hand with a long-arm mitten cast for three weeks. Preferred workhorse grafts are used in cases where the circumference of two independent digits is 22% larger than two conjoined digits, with an attempt to avoid grafts on the ring finger. The technique aims to achieve successful separation of fused digits while preserving the neurovascular structures and optimizing cosmetic outcomes.

Keywords

dorsal flap

skin grafts

complete syndactyly

digit fusion

dorsal commissure flap

palmar rectangular flap

Buck-Gramcko flaps

lateral nail fold reconstruction

neurovascular structures

full-thickness skin grafts