Patient-Reported Outcomes and Scar Assessment of Dorsal Omega Flap in Congenital Syndactyly Correction

Background: Congenital syndactyly is one of the most common congenital hand anomalies (1 in 3,000 live births). The ideal surgical technique must rebuild a satisfactory web space, restore digit abduction and avoid secondary contracture. The dorsal omega flap reduces the need for skin graft, thereby reducing web creep and contracture. There is a gap in literature on patient reported outcomes regarding the dorsal omega flap. We conducted a cross-sectional study to assess the outcomes patients operated with this technique. The aim of this study is to assess quality of life using Patient Reported Outcome Measures Information Systems (PROMIS^®) (upper extremity parent proxy short form) and to assess scar of dorsal omega flap subjectively using Visual analogue scale (VAS) and objectively using Vancouver Scar Score (VSS) and Withey score. Methods: Fifty-one children underwent congenital syndactyly correction between 2015 and 2021 at our institute. Seventeen children (45 webs) could be contacted for outpatient visit. Thirty-seven webs had undergone the dorsal omega flap. Withey's score and VSS for objective assessment of web and VAS for subjective scar assessment by parents. Parents were also administered the PROMIS^® (upper extremity parent proxy short form). The data analysis was performed using SPSS software (v22). Results: Patients who underwent surgery at least 4 years ago reported a higher median VSS (35) compared to those less than 4 years post-surgery (30). VAS and VSS showed improvement with time elapsed since surgery (ANOVA test), which was significant at p < 0.05. Median PROMIS^® score is lower in patients who had a graft used for coverage. But this was not significant statistically. The use of graft or the lack of it did not affect median VSS. Conclusions: PROMIS^® scores improve over time. The use of graft was associated with lower PROMIS^® scores. Older scars were of significantly better quality than more recent scars. Level of Evidence: Level IV (Therapeutic).