Nail fold creation in complete syndactyly using Buck-Gramcko pulp flaps.

Area of Science:

• Plastic Surgery
• Hand Surgery
• Pediatric Orthopedics

Background:

• Syndactyly, a congenital condition involving fused digits, often requires complex surgical intervention.
• Complete syndactyly of the fingers presents significant challenges for nail fold reconstruction.
• Established techniques may have limitations in achieving optimal aesthetic and functional outcomes.

Purpose of the Study:

• To evaluate the efficacy of the Buck-Gramcko double pulp flap technique for nail fold creation in syndactyly.
• To analyze nail patterns in complex syndactyly webs.
• To propose a novel classification system for nail patterns in syndactyly.

Main Methods:

• Surgical separation of 38 complete syndactyly webs in 27 patients.
• Application of the Buck-Gramcko double pulp flap technique for nail fold reconstruction in 75 fingertips.
• Detailed analysis of nail patterns and postoperative outcomes.

Main Results:

• Successful nail fold creation using the double pulp flap technique in a significant number of fingertips.
• Identification of distinct nail patterns within complex syndactyly webs.
• The proposed classification system aids in understanding and managing nail deformities.

Conclusions:

• The Buck-Gramcko double pulp flap technique is a viable and effective method for nail fold reconstruction in complex syndactyly.
• A new classification of nail patterns in syndactyly can improve surgical planning and outcome prediction.
• Further research can refine surgical approaches for syndactyly correction.