Long-terme Evaluation of Primary Syndactyly Treatment in Children, Using a Flatt Modified Technique

Objectives: The aim of the present study was to evaluate the results of web reconstruction in children with primary syndactyly, using the technique of Flatt modified by Upton for syndactyly release. Materials and methods: We reviewed 72 webs in 27 hands and 21 feet in 24 patients, operated for primary Corresponding author: Dr. Nacea Doina Iulia Plastic Surgery and Reconstructive Microsurgery Clinic Clinical Emergency Hospital “Grigore Alexandrecu”, Bucharest e-mail: [email protected] REZUMAT Evaluarea rezultatelor tratamentului sindactiliei primare la copii, utilizând pentru reconstrucåia spaåiilor interdigitale o variantã modificatã a tehnicii descrise de Flatt Obiective: Evaluarea rezultatelor tehnicii descrise de Flatt æi modificatã de Upton în tratamentul sindactiliei primare la copii. Materiale æi metode: Au fost evaluaåi 24 de pacienåi cu 72 de spaåii interdigitale operate (atât la mâini cât æi la picioare) pentru sindactilie primarã între 2002-2013 în Clinica de Chirurgie Plasticã æi Arsuri a Spitalului Clinic pentru Copiii „Grigore Alexandrescu”. Toate spaåiile interdigitale au fost reconstruite de cãtre acelaæ operator principal, aplicând aceleaæi indicaåii operatorii æi tehnicã chirurgicalã. Postoperator au fost urmãrite æi documentate: apariåia infecåiei, necroza lambourilor, integrarea grefelor, recitiva sindactiliei, contractura în flexie, devierea de ax, aspectul cicatricilor, sensibilitatea æi mobilitata degetelor . Rezultate: La niciunul dintre pacienåi nu s-a costatat postoperator infecåia , necroza lambourilor sau pierderea grefelor tegumentare. Recurenåa sindactiliei a fost înregistratã pentru 15 dintre cele 72 de spaåii reconstruite. Concluzii: Technica descrisã de Upton pentru tratamentul sindactiliei poate fi utilizatã cu succes atât în tratamentul sindactiliei membrelor superioare cât æi a celor inferioare, asociind o ratã scãzutã a complicaåiilor. Ea poate fi utilizatã æi în revizia recitivelor sindactiliei, fãrã a mai necesita utilizarea grefelor tegumentare. Cuvinte cheie: sindactilie primarã, tratament, grefe tegumentare, reconstrucåia comisurii, complicaåii Long-terme Evaluation of Primary Syndactyly Treatment in Children, Using a Flatt Modified Technique Doina-Iulia Nacea, D.M Enescu, Simona Stoicescu Plastic Surgery and Reconstructive Microsurgery Clinic, “Grigore Alexandrecu” Clinical Emergency Hospital, Bucharest, Romania “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania Original Paper Modern Medicine. 2015, Vol. 22, No. 2 : 102-107 Copyright© Celsius Long-Terme Evaluation of Primary Syndactyly Treatment in Children, Using a Flatt Modified Technique 103 syndactyly, during the period of 2002-2013 in the Plastic Surgery and Burns Department of “Grigore Alexandrescu’’ Clinical Emergency Hospital for Children. All the webs were corrected by the same surgeon, using the same indication, timing and technique. Skin grafts becoming loose, flap necrosis, development of local infection, web creep, flection contracture, finger deviation, scars, sensitivity and function were assessed clinically and documented. Results: There were no cases of loose skin graft or flap necrosis, and none of the patients developed local infection due to the surgery. Web creep was seen in 15 of the 72 released webs. Conclusion: The technique described by Upton for syndactyly release can be successfully applied both in the treatment of syndactyly of hands and feet. The incidence of complications is low. Revisional surgery for web creep can be performed using the same technique, without the use of skin grafts.