Double-Wing Flap for Polysyndactyly of the Fifth Toe

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Pediatric Surgery

Background:

• Polysyndactyly of the fifth toe fused with the fourth toe presents a surgical challenge.
• Assessing long-term clinical outcomes of surgical interventions is crucial for treatment efficacy.

Purpose of the Study:

• To investigate the long-term clinical outcomes of the double-wing flap technique.
• To evaluate the efficacy of the double-wing flap in treating polysyndactyly of the fifth toe fused with the fourth toe.

Main Methods:

• Retrospective analysis of 31 feet (27 patients) undergoing double-wing flap surgery for polysyndactyly.
• Follow-up period exceeding 5 years, assessing toe function, web reconstruction, and scar quality.
• Comparison of operated unilateral polysyndactyly with the contralateral normal side.

Main Results:

• Mean follow-up of 6.2 years with minimal long-term complications (2/31 feet experienced web creep).
• No statistically significant differences in toe abduction, web slope, or height compared to the normal side.
• High satisfaction rates with 23/31 webs rated as good based on D'Arcangelo's criterion.

Conclusions:

• The double-wing flap is a simple, safe, and effective surgical option for polysyndactyly.
• This technique avoids the need for skin grafts, offering cosmetic advantages.
• It is a viable alternative for treating polysyndactyly, particularly when cosmetic outcomes are prioritized.