A three-flap web-plasty for release of short congenital syndactyly and dorsal adduction contracture. 1991

D M Ostrowski, and C A Feagin, and J S Gould
Brookwood Orthopedic Associates, Birmingham, AL 35209.

This article describes a technique for interdigital web space deepening, which is applicable to incomplete syndactyly proximal to the proximal interphalangeal joint and to dorsal web space adduction contracture resulting from thermal injury. It consists of a dorsal rectangular flap and two palmar triangular flaps. The flaps are reversed to release dorsal adduction contracture. This procedure provides a broad commissure with a natural slope. A skin graft is avoided. A mathematical model shows that when the length-width ratio of the flaps is 1:1, the surface area of each flap is greater than or equal to the surface area of the defect it covers and the length of every flap edge is equal to or greater than its corresponding defect edge. If a web has a low apex angle and the skin is elastic, the length-width ratio may be as great as 1.5:1. The flaps will still cover the defects and small inequalities between certain flap and defect edges will be accommodated.

UI MeSH Term Description Entries
D008433 Mathematics The deductive study of shape, quantity, and dependence. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Mathematic
D003286 Contracture Prolonged shortening of the muscle or other soft tissue around a joint, preventing movement of the joint. Contractures
D006225 Hand The distal part of the arm beyond the wrist in humans and primates, that includes the palm, fingers, and thumb. Hands
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D013576 Syndactyly A congenital anomaly of the hand or foot, marked by the webbing between adjacent fingers or toes. Syndactylies are classified as complete or incomplete by the degree of joining. Syndactylies can also be simple or complex. Simple syndactyly indicates joining of only skin or soft tissue; complex syndactyly marks joining of bony elements. Polysyndactyly,Syndactylia,Syndactylias,Syndactylies

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