Limits...
Surgically induced digital distal syndactyly for prevention of digital growth deformities around the joints: a new technique.

Nazerani S, Kalantar Motamedi MH, Pirzeh A, Vahedian J, Nazerani T, Nazerani T - Trauma Mon (2012)

Bottom Line: Correction of digit deformities at or near the Joints is performed easily ; however, maintaining the result is often difficult either due to noncompliance of the patient to wear the postoperative splints or problems related to unequal growth of bones or normal tissues compared to the scarred or operated side.During the three postoperative weeks care is taken that this attachment is not disrupted and after healing a "distal syndactyly" is created which is very durable and in children it stretches with growth and does not impede the digit's growth.This technique by joining a deformed digit to a normally growing adjacent digit prevents the postoperative recurrence of the contracture or growth induced deviation in the digits of noncompliant patients especially children.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Tehran University of Medical Sciences, Firuzgar Medical Center, Tehran, IR Iran.

ABSTRACT

Background: Correction of digit deformities at or near the Joints is performed easily ; however, maintaining the result is often difficult either due to noncompliance of the patient to wear the postoperative splints or problems related to unequal growth of bones or normal tissues compared to the scarred or operated side.

Objectives: The aim of this study was to overcome the above mentioned problems for which we propose the "Distal d Digit Syndactyly" technique.

Materials and method: This method is based on the concept of suturing the distal phalanx of the deformed digit to the normal adjoining finger to help prevent the recurrence of the anomaly during the child's growth period or the very important three or four postoperative months of scar maturation in the adult. After the correction of deformity of the finger or toe, "Distal Syndactyly" is created by two flaps on the adjoining digits; one base is dorsally hinged and the other one volar and after elevating the flaps they are sutured together. During the three postoperative weeks care is taken that this attachment is not disrupted and after healing a "distal syndactyly" is created which is very durable and in children it stretches with growth and does not impede the digit's growth.

Results: Eleven patients with congenital and traumatic digit anomalies were treated. The recurrence of the problem was prevented in 9 patients; in 2 patients with intact Syndactyly the contracture recurred by stretching the Syndactyly skin. The period of the "Joining" ranged from 6 months to three years and cosmetic appearance was acceptable to the patient and parents.

Conclusion: This technique by joining a deformed digit to a normally growing adjacent digit prevents the postoperative recurrence of the contracture or growth induced deviation in the digits of noncompliant patients especially children.

No MeSH data available.


Related in: MedlinePlus

Postoperative result
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3860629&req=5

fig403: Postoperative result

Mentions: The flaps are elevated carefully under magnification to prevent damage to the vascular and neural structures beneath them. The flaps are then joined by absorbable sutures (Figures 3, 4). The donor raw surfaces on the fingers are left to heal and no closure or skin graft is needed. After the wounds heal, the Syndactyly acts as a living orthosis or "Buddy taping" preventing the recurrence of contractureor joint deformity and helps the operated digit's function by the movements of the normal digit(Figures 5, 6). During the first few postoperative weeks care is taken that this „jointing‟ is not disrupted and after healing a "distal Syndactyly" is created which is very durable. It is noteworthy that with time the Syndactyly stretches and does not bend the longer finger. During the first two weeks the hygiene of the fingers is a bit difficult to maintain because of fear of disruption of the joining flaps and must be done by the medical personnel; however, after this time hygiene can be easily maintained by cleaning the web via swabs and the parents can themselves do it. We have not observed any maceration of the web space in this group of patients. We use no Wires whatsoever to hold the flaps together and usually it takes around two weeks for the flap to heal,during this time the digits should be taped to prevent flap separation.


Surgically induced digital distal syndactyly for prevention of digital growth deformities around the joints: a new technique.

Nazerani S, Kalantar Motamedi MH, Pirzeh A, Vahedian J, Nazerani T, Nazerani T - Trauma Mon (2012)

Postoperative result
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860629&req=5

fig403: Postoperative result
Mentions: The flaps are elevated carefully under magnification to prevent damage to the vascular and neural structures beneath them. The flaps are then joined by absorbable sutures (Figures 3, 4). The donor raw surfaces on the fingers are left to heal and no closure or skin graft is needed. After the wounds heal, the Syndactyly acts as a living orthosis or "Buddy taping" preventing the recurrence of contractureor joint deformity and helps the operated digit's function by the movements of the normal digit(Figures 5, 6). During the first few postoperative weeks care is taken that this „jointing‟ is not disrupted and after healing a "distal Syndactyly" is created which is very durable. It is noteworthy that with time the Syndactyly stretches and does not bend the longer finger. During the first two weeks the hygiene of the fingers is a bit difficult to maintain because of fear of disruption of the joining flaps and must be done by the medical personnel; however, after this time hygiene can be easily maintained by cleaning the web via swabs and the parents can themselves do it. We have not observed any maceration of the web space in this group of patients. We use no Wires whatsoever to hold the flaps together and usually it takes around two weeks for the flap to heal,during this time the digits should be taped to prevent flap separation.

Bottom Line: Correction of digit deformities at or near the Joints is performed easily ; however, maintaining the result is often difficult either due to noncompliance of the patient to wear the postoperative splints or problems related to unequal growth of bones or normal tissues compared to the scarred or operated side.During the three postoperative weeks care is taken that this attachment is not disrupted and after healing a "distal syndactyly" is created which is very durable and in children it stretches with growth and does not impede the digit's growth.This technique by joining a deformed digit to a normally growing adjacent digit prevents the postoperative recurrence of the contracture or growth induced deviation in the digits of noncompliant patients especially children.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Tehran University of Medical Sciences, Firuzgar Medical Center, Tehran, IR Iran.

ABSTRACT

Background: Correction of digit deformities at or near the Joints is performed easily ; however, maintaining the result is often difficult either due to noncompliance of the patient to wear the postoperative splints or problems related to unequal growth of bones or normal tissues compared to the scarred or operated side.

Objectives: The aim of this study was to overcome the above mentioned problems for which we propose the "Distal d Digit Syndactyly" technique.

Materials and method: This method is based on the concept of suturing the distal phalanx of the deformed digit to the normal adjoining finger to help prevent the recurrence of the anomaly during the child's growth period or the very important three or four postoperative months of scar maturation in the adult. After the correction of deformity of the finger or toe, "Distal Syndactyly" is created by two flaps on the adjoining digits; one base is dorsally hinged and the other one volar and after elevating the flaps they are sutured together. During the three postoperative weeks care is taken that this attachment is not disrupted and after healing a "distal syndactyly" is created which is very durable and in children it stretches with growth and does not impede the digit's growth.

Results: Eleven patients with congenital and traumatic digit anomalies were treated. The recurrence of the problem was prevented in 9 patients; in 2 patients with intact Syndactyly the contracture recurred by stretching the Syndactyly skin. The period of the "Joining" ranged from 6 months to three years and cosmetic appearance was acceptable to the patient and parents.

Conclusion: This technique by joining a deformed digit to a normally growing adjacent digit prevents the postoperative recurrence of the contracture or growth induced deviation in the digits of noncompliant patients especially children.

No MeSH data available.


Related in: MedlinePlus