Clinical experience using the dorsal reverse metacarpal flap for the treatment of congenital syndactyly: report of four cases.

Skin grafts and local flaps are conventional methods of repair for simple complete syndactyly, but the results obtained are not always as functional and aesthetic as desired and frequently leave postoperative scars and residual syndactyly. In this article, we describe a new surgical technique for the correction of syndactyly that utilizes a metacarpal dorsal reverse flap to provide skin coverage to the interdigital space and also to 1 side of the finger, therefore avoiding the use of skin grafts and resulting postoperative scar contracture. We report 4 cases using this procedure, with a 12-month follow up. The technique is safe, easily performed, and reproducible and requires a single surgical procedure. It uses donor tissue identical in color, texture, and thickness, which renders acceptable cosmesis and good hand function.