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

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.