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Syndactyly correction using a venous flap with the plantar cutaneous venous arch
Natsuki Sakamoto1, Hajime Matsumura, Takako Komiya
1From the Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
Annals of Plastic Surgery
|May 21, 2014
Summary
This study presents a novel surgical technique for syndactyly reconstruction, utilizing a plantar flap with a venous arch to prevent ischemia. This method ensures stable flap circulation and successful web space creation in toe syndactyly repair.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Syndactyly reconstruction commonly employs skin grafts and local flaps.
- Plantar flaps are often used for unilateral toe syndactyly but risk ischemia or congestion.
- A need exists for improved flap viability in toe syndactyly repair.
Observation:
- A modified plantar flap incorporating the plantar cutaneous venous arch via a triangular venous flap was used.
- This technique was applied to cover the lateral side of the web in seven syndactyly cases.
- The dorsal flap was utilized for new web creation, with skin grafts for the contralateral side.
Findings:
- The modified plantar flap demonstrated stable circulation without congestion or ischemia in all seven patients.
- The flap pedicle was narrow, facilitating simple flap relocation.
- Post-operative follow-up confirmed patent new web spaces with no evidence of contraction.
Implications:
- This technique offers a reliable alternative to standard plantar flaps for syndactyly reconstruction.
- Preserving flap viability through venous arch incorporation enhances surgical outcomes.
- The method simplifies the procedure and improves aesthetic and functional results in toe syndactyly repair.