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

A method is described of creating nail-folds in the release of cases of complete syndactyly. A double pulp flap was used as a one-stage technique in 13 patients in whom webs were separated. All patients were reviewed after a minimum of one year. Fullness of pulp was achieved in all fingers. The nail-fold was considered normal in 14 of 18 fingers covered with a broad flap and in 8 of 18 fingers covered with a narrow flap. In the remaining cases the nail-fold was small but never absent. No flap loss was encountered and there was no late nail deformity from scarring.