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Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
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[Spare-parts concept in pediatric hand: About one bilateral syndactyly]
M-V Truffandier1, P Perrot1, F Duteille1
1Service de brûlés-chirurgie plastique, CHU de Nantes, 30, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
Introduction:
The spare-parts concept is well described in traumatology of the hand. Tissues of a scarified ray are used to reconstruct another damaged finger. We will detail an application in pediatric hand through a clinical case.
Materials And Method:
We describe a patient presenting a bilateral complete and non-complex syndactyly of the third web space associated with a bilateral hexadactyly classified as type B according to the Temtamy and Mc Kusick's classification. The treatment of the syndactyly was performed with a dorsal flap for the web space and with longitudinal zigzag incisions in mirror. Skin loss of the lateral sides of the fingers was covered by the full-thickness graft taken on the supernumerary finger which was treated in the same surgical time.
Discussion:
This application of the spare-parts concept allows only one surgical site with absence of scar on the donor site and a skin graft close to the skin loss on the finger.
Conclusion:
The spare-parts concept can be applied in some cases of pediatric hand and must be a tool for the surgeon.
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