EFFECTIVENESS OF DORSAL PENTAGONAL FLAP FOR RECONSTRUCTION OF THE WEB SPACE IN CONGENITAL TOE SYNDACTYLY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TAOXianyao , WANGLong ,  GAOWeiyang , DINGJian , FENGXiaoliang , WANGAnyuan , SONGYonghuan

Department of Hand Microsurgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, P. R. China;

Corresponding author：

GAOWeiyang, Email: wygao1@163.com

Keywords：

Congenital toe syndactyly; Pentagonal flap; Web space

DOI：

10.7507/1002-1892.20150242

Video：

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Objective To investigate the effectiveness of dorsal pentagonal flap for reconstruction of the web space in congenital toe syndactyly. Methods Between January 2009 and June 2014, 10 patients with congenital toe syndactyly were treated for web space reconstruction with dorsal pentagonal flap. There were 6 boys and 4 girls with the average age of 42 months (range, 8 months to 9 years). The congenital toe syndactyly located at the left foot in 5 cases, the right foot in 4 cases, and both feet in 1 case; 7 patients had polydactyly and 1 patient had brachydactylia. During followup, the toe function and web space appearance, web space depth, and web space gradient were observed to evaluate the effectiveness. Results All 13 flaps survived and incisions healed by first intention. Ten patients were followed up 6-50 months (mean, 26 months). The skin color and texture in 13 reconstructed web spaces were close to normal web space. In 9 patients undergoing web spaces reconstruction of single foot, the abduction angle of toes was (42.879±3.703)° at the injured side, showing no significant difference when compared with the normal side [(45.922±2.657)°] (t=-2.004, P=0.062); the web space depth was (1.881±0.266) cm at the injured side and was (1.631±0.202) cm at the normal side, showing significant difference (t=2.248, P=0.039); and the web space gradient was (42.733±3.421)° at the injured side and was (41.189±5.593)° at the normal side, showing no significant difference (t=0.707, P=0.490). The web space appearance, web space depth, and web space gradient were close to those of the normal web space in 1 patient undergoing bilateral web spaces reconstruction. Conclusion Web space reconstruction with dorsal pentagonal flap is easy to perform with reliable blood supply and low re-operated rate. The cosmetic and functional results are satisfactory.

Citation： TAOXianyao, WANGLong, GAOWeiyang, DINGJian, FENGXiaoliang, WANGAnyuan, SONGYonghuan. EFFECTIVENESS OF DORSAL PENTAGONAL FLAP FOR RECONSTRUCTION OF THE WEB SPACE IN CONGENITAL TOE SYNDACTYLY. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(9): 1117-1120. doi: 10.7507/1002-1892.20150242 Copy

1.	Keret D, Ger E. Evaluation of a uniform operative technique to treat syndactyly. J Hand Surg (Am), 1987, 12(5 Pt 1):727-729.
2.	Tan O, Atik B, Ergen D. Versatile use of the VM-plasty for reconstruction of the web space. Ann Plast Surg, 2005, 55(6):623-628.
3.	吴守成, 宋建良, 姚建民, 等. M-W皮瓣在指(趾)蹼重建中的临床应用. 中华手外科杂志, 2002, 18(2):101-102.
4.	陶忠生, 冯亚高, 张向宁, 等. 32例先天性并指畸形的手术治疗. 实用手外科杂志, 2011, 25(3):234-235.
5.	吴迪, 路来金, 宣昭鹏, 等. 先天性并指畸形治疗的回顾性分析. 实用手外科杂志, 2013, 27(2):121-123.
6.	张平, 刘娟. 掌背皮瓣在幼儿先天性并指分指中的应用. 中华小儿外科杂志, 2014, 35(7):530-534.
7.	Lim YJ, Teoh LC, Lee EH. Reconstruction of syndactyly and polysyndactyly of the toes with a dorsal pentagonal island flap:a technique that allows primary skin closure without the use of skin grafting. J Foot Ankle Surg, 2007, 46(2):86-92.
8.	岳震, 路来金, 宫旭, 等. 掌(足)背五角形皮瓣重建先天性并指(趾) 指蹼的临床应用. 中华手外科杂志, 2013, 29(3):136-138.
9.	高伟阳, 王安远, 蒋良福, 等. 指背五边形皮瓣重建先天性并指指蹼. 中华手外科杂志, 2010, 26(4):193-194.
10.	Gao W, Yan H, Zhang F, et al. Dorsal pentagonal local flap:a new technique of web reconstruction for syndactyly without skin graft. Aesthetic Plast Surg, 2011, 35(4):530-537.
11.	王安远, 高伟阳, 解学关, 等. 指背五边形皮瓣重建指蹼治疗先天性并指的疗效分析. 中华整形外科杂志, 2010, 26(5):325-328.
12.	郭雷洋, 曹莫, 丁洋. 左足趾瘢痕疙瘩一例. 中华整形外科杂志, 2012, 28(4):308-309.
13.	Muzaffar AR, Rafols F, Masson J, et al. Keloid formation after syndactyly reconstruction:associated conditions, prevalence, and preliminary report of a treatment method. J Hand Surg (Am), 2004, 29(2):201-208.
14.	杜作晨, 田晓菲, 邱林, 等. 伴第4、5趾并趾的小趾多趾畸形的外观与骨关节表现差异分析. 中华整形外科杂志, 2015, 31(2):102-106.
15.	Lee HS, Park SS, Yoon JO, et al. Classification of postaxial polydactyly of the foot. Foot Ankle Int, 2006, 27(5):356-362.

1. Keret D, Ger E. Evaluation of a uniform operative technique to treat syndactyly. J Hand Surg (Am), 1987, 12(5 Pt 1):727-729.
2. Tan O, Atik B, Ergen D. Versatile use of the VM-plasty for reconstruction of the web space. Ann Plast Surg, 2005, 55(6):623-628.
3. 吴守成, 宋建良, 姚建民, 等. M-W皮瓣在指(趾)蹼重建中的临床应用. 中华手外科杂志, 2002, 18(2):101-102.
4. 陶忠生, 冯亚高, 张向宁, 等. 32例先天性并指畸形的手术治疗. 实用手外科杂志, 2011, 25(3):234-235.
5. 吴迪, 路来金, 宣昭鹏, 等. 先天性并指畸形治疗的回顾性分析. 实用手外科杂志, 2013, 27(2):121-123.
6. 张平, 刘娟. 掌背皮瓣在幼儿先天性并指分指中的应用. 中华小儿外科杂志, 2014, 35(7):530-534.
7. Lim YJ, Teoh LC, Lee EH. Reconstruction of syndactyly and polysyndactyly of the toes with a dorsal pentagonal island flap:a technique that allows primary skin closure without the use of skin grafting. J Foot Ankle Surg, 2007, 46(2):86-92.
8. 岳震, 路来金, 宫旭, 等. 掌(足)背五角形皮瓣重建先天性并指(趾) 指蹼的临床应用. 中华手外科杂志, 2013, 29(3):136-138.
9. 高伟阳, 王安远, 蒋良福, 等. 指背五边形皮瓣重建先天性并指指蹼. 中华手外科杂志, 2010, 26(4):193-194.
10. Gao W, Yan H, Zhang F, et al. Dorsal pentagonal local flap:a new technique of web reconstruction for syndactyly without skin graft. Aesthetic Plast Surg, 2011, 35(4):530-537.
11. 王安远, 高伟阳, 解学关, 等. 指背五边形皮瓣重建指蹼治疗先天性并指的疗效分析. 中华整形外科杂志, 2010, 26(5):325-328.
12. 郭雷洋, 曹莫, 丁洋. 左足趾瘢痕疙瘩一例. 中华整形外科杂志, 2012, 28(4):308-309.
13. Muzaffar AR, Rafols F, Masson J, et al. Keloid formation after syndactyly reconstruction:associated conditions, prevalence, and preliminary report of a treatment method. J Hand Surg (Am), 2004, 29(2):201-208.
14. 杜作晨, 田晓菲, 邱林, 等. 伴第4、5趾并趾的小趾多趾畸形的外观与骨关节表现差异分析. 中华整形外科杂志, 2015, 31(2):102-106.
15. Lee HS, Park SS, Yoon JO, et al. Classification of postaxial polydactyly of the foot. Foot Ankle Int, 2006, 27(5):356-362.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF DORSAL PENTAGONAL FLAP FOR RECONSTRUCTION OF THE WEB SPACE IN CONGENITAL TOE SYNDACTYLY

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