New Surgical Technique for Cleft Hand and Foot Using a Lateral Pantaloon Flap.

Various surgical techniques for cleft hand closure have been reported. Cleft closure aims to improve cosmetic appearance, and the form of interdigital spaces should be drawn closer to normal. Further innovations are required to reconstruct natural interdigital contours. The pantaloon flap used in syndactyly surgery provides a natural interdigital formation. We focused on this aspect and used the pantaloon flap as a lateral stem for cleft hand closure. This technique was applied in 3 cases of cleft hand (4 hands) and 2 cases of cleft foot (2 feet), classified as Manske types I, IIA, III, and IV and Ogino types 1, 2, and 4, respectively. The mean age at surgery was 11 months, and the mean follow-up period was 13 years and 2 months. Consequently, an appropriate interdigital form was reconstructed. The maximum follow-up duration was 26 years. Here, we describe the lateral pantaloon flap technique for cleft hand closure. This technique provides stable long-term results and can be applied to any cleft hand or foot without bony deformities requiring osteotomy.