Foot Syndactyly: A Clinical and Demographic Analysis

Kim, Jong Ho; Kim, Byung Jun; Kwon, Sung Tack

doi:10.5999/aps.2016.43.6.559

Cited by 9 publications

(15 citation statements)

References 14 publications

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“…Although these techniques can obtain good results, these techniques need to be specially designed, as recurrences with more serious scars are common. [ 9 ]…”

Section: Introductionmentioning

confidence: 99%

The use of a dorsal double-wing flap without skin grafts for congenital syndactyly treatment

Dong

Wang

2017

Medicine

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Numerous techniques have been developed that use various flaps to treat syndactyly. Skin grafts have often been used to cover remaining surgical defects. The long-term aim of surgery is to find new methods of separating the digits without using skin grafts. This paper describes a new surgical technique for the correction of simple, incomplete, and complete syndactyly. The technique consists of a dorsal double-wing flap to cover the newly created web space and zigzag incisions in the fingers, thus avoiding the use of skin grafts in this space. Overall, 35 web spaces in 24 patients were treated using this technique. Patient follow-up ranged from 6 months to nearly 5 years. There were no complications such as hematoma, infection or flap necrosis, and no fingers needed skin grafts after separation. The average operative time for each web space was approximately 45 minutes. Ninety-seven percent of patients treated with the dorsal double-wing flap procedure achieved good function, and superior cosmetic results following a single surgery. The technique is simple, rapid, safe, and easily performed and does not require the use of skin grafts.

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“…Although these techniques can obtain good results, these techniques need to be specially designed, as recurrences with more serious scars are common. [ 9 ]…”

Section: Introductionmentioning

confidence: 99%

The use of a dorsal double-wing flap without skin grafts for congenital syndactyly treatment

Dong

Wang

2017

Medicine

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“…Polydactyly of the foot is among the most commonly encountered anomalies of the limbs, and accounts for 45% of congenital foot abnormalities [8][9][10]. This condition results from established genetic syndromes in some cases, but most frequently occurs as an isolated trait with an autosomal dominant pattern of inheritance and variable expressivity (gene penetrance) [11].…”

Section: Discussionmentioning

confidence: 99%

Case-control study of the treatment of postaxial polysyndactyly of the foot: Comparison of surgical results after removal of the fifth or sixth toe

2021

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Background In postaxial polysyndactyly of the foot, the choice of which toe to excise is controversial. It is often treated by resection of the fifth toe to save the lateral neurovascular bundles of the sixth toe. However, the sixth toe is often short and laterally deviated, which may require wedge osteotomy, potentially shortening the phalanx and compromising circulation. This study outlines an individualized method to spare the length and axis of the fifth toe in polysyndactyly with a short and deviated sixth toe.Methods We retrospectively analyzed 38 patients who underwent surgery between 2006 and 2019. The fifth toe was spared in 18 cases, and the sixth toe in 20 cases. The ratios of the forefoot width, angle difference, and toe length were compared between the affected and unaffected sides postoperatively. Complications and subjective judgments on cosmetic results were recorded and compared.Results No significant between-group differences were observed for sex, age at surgery, or the follow-up period. The forefoot width ratio did not significantly differ between the groups. However, the angle difference and toe length ratios showed significantly better results in the fifth toe-spared group than in the sixth toe-spared group (P<0.05 and P<0.01, respectively). There were no cases of impaired circulation, and subjective evaluations revealed satisfactory results in the fifth toe-spared group.Conclusions In cases with short and deviated sixth toes, sparing the fifth toe is an effective method of cosmetic treatment. The surgical results were satisfactory, with an improved appearance and no residual deformities.

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“…Distal migration or recurrence of the web following surgery for syndactyly is termed “web creep” in the literature. 6,17,19 Grading of web creep in hand syndactyly has been introduced. 19 However, web creep in foot syndactyly has been less frequently discussed, 6 although syndactyly affects the foot more frequently than the hand.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes and Predictive Factors of Medial Toe Excision for Polysyndactyly of the Fifth Toe

Shim

Kang

et al. 2020

Foot Ankle Int.

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Background: We aimed to report surgical outcomes and analyze prognostic factors of medial toe excision for polysyndactyly of the fifth toe. Methods: We reviewed the details of 139 consecutive patients who underwent surgery for postaxial polydactyly of the foot from 2009 to 2018. Among these, 83 patients (90 feet) with polysyndactyly of the fifth toe, treated by medial toe excision (between the duplicated toes) and reconstruction of the fourth web space using a dorsal rectangular flap, were included. The toe alignment and stability were restored by chondroplasty and soft tissue balancing without an osteotomy. A full-thickness skin graft was performed in 52 feet. The mean age at surgery was 27.1 ± 17.5 months and the mean duration of follow-up was 42.8 ± 24.9 months. Results: At the last follow-up, a relatively small size of the reconstructed toe was observed in 19 feet (19/90, 21.1%). Proximal duplication level (metatarsal or proximal phalanx type) and preoperative hypoplasia of the remaining toe were related to the small postoperative size. Valgus deformity of the remaining toe was observed in 2 feet (2/90, 2.2%). We observed 17 cases with delayed healing or early postoperative wound infection. Among these, 7 cases (7/90, 7.8%) showed postoperative thickening or advancement of the web, which was not observed in cases without wound problems. No cases had functional disturbance or pain. Conclusion: The overall surgical outcomes were satisfactory without an osteotomy. Patients with a proximal duplication level or preoperative hypoplasia of the remaining toe should be informed of its possible small size postoperatively. Levels of Evidence: Level IV, retrospective case series.

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Foot Syndactyly: A Clinical and Demographic Analysis

Cited by 9 publications

References 14 publications

The use of a dorsal double-wing flap without skin grafts for congenital syndactyly treatment

The use of a dorsal double-wing flap without skin grafts for congenital syndactyly treatment

Case-control study of the treatment of postaxial polysyndactyly of the foot: Comparison of surgical results after removal of the fifth or sixth toe

Surgical Outcomes and Predictive Factors of Medial Toe Excision for Polysyndactyly of the Fifth Toe

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