Bilobed flap for web reconstruction in adult syndactyly release: A new technique that can avoid the use of skin graft

SummaryAimThe aim of the study was to describe the use of a bilobed flap for web formation of syndactyly release, which decreases the need for graft and also avoids the use of skin grafting in syndactyly cases.MethodsA retrospective review of this procedure was performed for 15 web space reconstructions. Patients were aged 20–23 years. The mean follow-up period was 7–12 months (mean 7 + 3.2). The operations were performed for the beneficial use of the dorsal hand skin by lowering the need for a skin graft. The flap was on the dorsum of the hand and proximal phalanx and was used for web formation.ResultsSurgery was completed without skin grafting in nine cases of 14 web spaces; two of them were complex/complete syndactylies, and two of them were simple/complete syndactylies. We used a skin graft in one patient because of triangular flap necrosis in a second operation. The use of a bilobed flap allowed the construction of web spaces, providing satisfactory cosmetic outcomes. No partial necrosis or complications was observed in bilobed flaps. No secondary correction was needed during the follow-up period.ConclusionThe present surgical technique could be a new surgical option for web formation and reconstruction in primary and secondary cases, especially in an adult population in which the skin on the dorsum of the hand is more pliable.Level of Evidence: IV.