Elsheshtawy, H., Elsayed, M., Elshebly, A., Bahaa El Din, A. (2024). Outcomes of V-Y Dorsal Metacarpal Artery Perforator Flap for Web Space Reconstruction in Simple Syndactyly. The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), 183-190. doi: 10.21608/ejprs.2024.365326
Hossam Mahmoud Elsheshtawy; Magdi Beshir Elsayed; Ahmed Mahmoud Elshebly; Ahmed Mohamed Bahaa El Din. "Outcomes of V-Y Dorsal Metacarpal Artery Perforator Flap for Web Space Reconstruction in Simple Syndactyly". The Egyptian Journal of Plastic and Reconstructive Surgery, 48, 3, 2024, 183-190. doi: 10.21608/ejprs.2024.365326
Elsheshtawy, H., Elsayed, M., Elshebly, A., Bahaa El Din, A. (2024). 'Outcomes of V-Y Dorsal Metacarpal Artery Perforator Flap for Web Space Reconstruction in Simple Syndactyly', The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), pp. 183-190. doi: 10.21608/ejprs.2024.365326
Elsheshtawy, H., Elsayed, M., Elshebly, A., Bahaa El Din, A. Outcomes of V-Y Dorsal Metacarpal Artery Perforator Flap for Web Space Reconstruction in Simple Syndactyly. The Egyptian Journal of Plastic and Reconstructive Surgery, 2024; 48(3): 183-190. doi: 10.21608/ejprs.2024.365326
Outcomes of V-Y Dorsal Metacarpal Artery Perforator Flap for Web Space Reconstruction in Simple Syndactyly
1The Department of Plastic & Reconstructive Surgery* , Faculty of Medicine, Mansoura University
2The Department of General Surgery, Faculty of Medicine, Mansoura University
3The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Mansoura University
Abstract
Background: New web space formation is the most challenging in the treatment of syndactyly, and the choice of the ideal reconstructive technique is still controversial. Syndactyly repairs using skin grafts increase the risk of graft-related complications. The V-Y dorsal metacarpal artery perforator flap offers a method of syndactyly release that can eliminate the need for skin grafts. In this study to allow for further progress of the flap, we guarantee free dissection of the dorsal metacarpal vessels. Objective: To evaluate the outcomes of simple syndactyly web space reconstruction with V-Y dorsal metacarpal artery perforator flap. Method: Surgically treated 14 patients diagnosed with simple syndactyly were included in the study. Postoperative results were clinically evaluated by two independent surgeons as regards early postoperative infection, hematoma, congestion, flap necrosis, and long-term results such as web creep < br />grade, finger deformity, Vancouver scar scale (VSS), contracture, range of motion, and parents “or patients” visual analogue scale (VAS) for aesthetic satisfaction. Results: All 14 flaps survived well apart from two flaps that showed distal tip necrosis. All cases had normal MCP range of motion, and only two cases had extension lag. Flexion deformity was found in two cases only. As regards web creep, seven cases developed web creep grade I, five cases were grade II, and two cases were grade III. The total median value of the scar quality on the Vancouver Scar scale (VSS) was 5.43 [range 4-7]. The average total satisfaction of patients/caregivers was 8.14 [range 5-10]. Conclusion: The V-Y dorsal metacarpal artery perforator flap is a reliable option for web space reconstruction in simple syndactyly.
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