ABSTRACT
BACKGROUND: This study describes the use of a modified "bell-bottom" flap for treatment of partial syndactyly release that may avoid the use of skin grafting. METHODS: A retrospective review of this procedure was performed for 12 interdigital space reconstructions. Patients were aged 1 to 5 years 6 months. The mean follow-up period was 24 months. The operations were performed to avoid skin grafting. The flap was designed in the narrow-spaced and fused interdigital region of syndactyly for preventing postoperative scar contracture and web formation. RESULTS: Surgery was completed without skin grafting in all cases. The use of a modified flap allowed the construction of interdigital spaces with sufficient width, providing satisfactory cosmetic outcomes. No partial necrosis or complications were observed. No web formation, elevation of the interdigital space, or limited range of joint motion caused by contracture was observed during the 2-year follow-up period, and no secondary correction was needed. CONCLUSION: The present surgical technique may be a new surgical option for web release in which fingers are fused at a level lower than the midpoint between the proximal and distal interphalangeal joints. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
Subject(s)
Plastic Surgery Procedures/methods , Surgical Flaps , Syndactyly/surgery , Child, Preschool , Cicatrix/prevention & control , Cohort Studies , Contracture/prevention & control , Follow-Up Studies , Humans , Infant , Male , Recovery of Function , Retrospective Studies , Risk Assessment , Skin Transplantation , Syndactyly/diagnosis , Treatment OutcomeABSTRACT
Various methods of managing patients with lagophthalmos secondary to paralysis of the facial nerve have been reported. While addition of a gold plate facilitates displacement of the upper eyelid downwards, coaptation of the lid margin is often incomplete because of coexisting ectropion of the lower lid. The outcome obtainable from loading the lid with a gold plate alone is often unsatisfactory. To manage the deformity by combining the loading of the lid with gold plate and lateral canthopexy is technically simple. Morbidity is minimal as it can be done under local anaesthesia. Adequacy of coaption of the palpebral margin could be assessed immediately. We have managed a total of seven (mainly elderly) such patients between 1999 and 2000 in our hospitals. The outcome was generally satisfactory and there were no complications.
