Outcomes of V-Y Dorsal Metacarpal Artery Perforator Flap for Web Space Reconstruction in Simple Syndactyly

Document Type : Original Article

Authors

1 The Department of Plastic & Reconstructive Surgery* , Faculty of Medicine, Mansoura University

2 The Department of General Surgery, Faculty of Medicine, Mansoura University

3 The 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.

Keywords

Main Subjects

References

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