New Surgical Technique for Cleft Hand and Foot Using a Lateral Pantaloon Flap

Area of Science:

• Plastic and Reconstructive Surgery
• Congenital Hand and Foot Anomalies
• Microsurgery and Flap Techniques

Background:

• Cleft hand and foot closures aim to normalize interdigital spaces and improve aesthetics.
• Existing surgical techniques often require further innovation for natural interdigital contour reconstruction.
• The pantaloon flap, successful in syndactyly, offers potential for natural interdigital formation.

Purpose of the Study:

• To describe and evaluate the lateral pantaloon flap technique for cleft hand and foot closure.
• To assess the efficacy of this technique in reconstructing natural interdigital contours.
• To determine the long-term stability and applicability of the lateral pantaloon flap in cleft deformities.

Main Methods:

• Application of the lateral pantaloon flap as a pedicled flap for cleft closure.
• Surgical intervention in 3 cases of cleft hand (4 hands) and 2 cases of cleft foot (2 feet).
• Classification of cases according to Manske (I, IIA, III, IV) and Ogino (1, 2, 4) types.
• Mean age at surgery: 11 months; mean follow-up: 13 years 2 months; maximum follow-up: 26 years.

Main Results:

• Successful reconstruction of appropriate interdigital form in all treated cleft hands and feet.
• Stable, long-term aesthetic and functional outcomes observed throughout the follow-up period.
• The technique demonstrated versatility across various Manske and Ogino classifications.

Conclusions:

• The lateral pantaloon flap technique is effective for cleft hand and foot closure, achieving natural interdigital contours.
• This method provides stable, durable results suitable for a wide range of cleft deformities.
• The technique is applicable to cleft hands and feet without significant bony deformities requiring osteotomy.