The hinged digit flap with dual W-plasties.

Area of Science:

• Plastic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Digital reconstruction presents unique challenges due to joint mobility and thin skin.
• Scarring over joints can lead to significant functional impairment and contractures.
• Effective flap design is crucial for successful digital reconstruction.

Purpose of the Study:

• To evaluate the efficacy of a specific U-shaped flap design for digit reconstruction.
• To assess the necessity and effectiveness of dual-running W-plasties in preventing complications over digital joints.
• To report outcomes in a series of patients undergoing this reconstructive technique.

Main Methods:

• A proximally hinged, distally incised U-shaped flap was utilized for digital reconstruction.
• Dual-running W-plasties were incorporated when incisions crossed joint lines.
• A retrospective review of 18 consecutive cases was performed.

Main Results:

• The U-shaped flap demonstrated good adaptability to the contours of digits.
• The use of dual-running W-plasties successfully prevented cicatricial bridging over joint areas.
• No significant complications or functional compromise were observed in the series of 18 cases.

Conclusions:

• The described U-shaped flap is a reliable and effective method for digit reconstruction.
• Dual-running W-plasties are a critical modification for flaps incised over digital joints.
• This technique offers a safe approach with favorable functional outcomes in digital reconstruction.