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An experience of the Snow-Littler procedure
M A Rider1, S I Grindel, M A Tonkin
1University of Sydney and the Department of Hand Surgery, Royal North Shore Hospital, Australia.
Journal of Hand Surgery (Edinburgh, Scotland)
|November 1, 2000
Summary
The Snow-Littler procedure effectively improved appearance and function in hands with central longitudinal deficiency or symbrachydactyly. While minor complications occurred, the overall outcomes for thumb reconstruction were positive.
Area of Science:
- Hand surgery
- Congenital hand differences
- Microsurgery
Background:
- Central longitudinal deficiency and symbrachydactyly are congenital hand differences requiring surgical correction.
- The Snow-Littler procedure is a reconstructive technique for these conditions.
Purpose of the Study:
- To review the outcomes of the Snow-Littler procedure in patients with central longitudinal deficiency and symbrachydactyly.
- To evaluate the procedure's impact on hand appearance and function.
Main Methods:
- Retrospective review of thirteen hands (12 central longitudinal deficiency, 1 symbrachydactyly) treated with the Snow-Littler procedure.
- Assessment of flap viability, webspace width, need for grafting, and transverse metacarpal ligament reconstruction.
Main Results:
- No major flap necrosis; two flaps had tip ischemia. First web width was generally satisfactory, with four revisions. Skin grafting was needed in complex syndactylies and symbrachydactyly.
- Transverse metacarpal ligament reconstruction was performed in eight cases; the remaining five showed no instability without it. Three de-rotational osteotomies were done.
- The Snow-Littler procedure demonstrated significantly improved appearance and function.
Conclusions:
- The Snow-Littler procedure is a viable option for correcting central longitudinal deficiency and symbrachydactyly.
- The procedure leads to favorable aesthetic and functional results, with manageable complications.