A double pulp flap technique for creating nail-folds in syndactyly release

Area of Science:

• Plastic Surgery
• Hand Surgery
• Congenital Hand Anomalies

Background:

• Syndactyly, the fusion of digits, presents significant challenges in hand reconstruction.
• Creating functional and aesthetically pleasing nail-folds after syndactyly release is crucial for optimal outcomes.

Purpose of the Study:

• To evaluate the efficacy of a one-stage double pulp flap technique for nail-fold reconstruction in complete syndactyly.
• To assess the long-term outcomes and patient satisfaction following this surgical approach.

Main Methods:

• A retrospective review of 13 patients undergoing syndactyly release using a double pulp flap technique.
• Surgical separation of fused digits followed by reconstruction using broad and narrow flaps.
• Minimum one-year follow-up to assess nail-fold morphology, pulp fullness, and complications.

Main Results:

• Complete pulp fullness was achieved in all operated fingers.
• Normal nail-fold formation was observed in 78% of fingers covered with broad flaps and 44% with narrow flaps.
• Minor nail-folds were present in all remaining cases; no flap loss or late scarring deformities occurred.

Conclusions:

• The one-stage double pulp flap technique is a safe and effective method for syndactyly release and nail-fold reconstruction.
• Broad flaps appear to yield better aesthetic and functional results for nail-fold formation compared to narrow flaps.