Spearhead procedure for repair of web space burn sequelae

Postburn dorsal and palmar interdigital commissural contractures: Anatomy and treatment—A new approach

“…Other flaps and techniques that had been recommended are as follows: five-flap, Y-V advancement with Z-plasty [12]; reverse triangular V-Y flaps, using two reverse V-Y island triangular flaps [13]; five-flap technique which combines a double opposing Z-plasty and with a Y-V plasty [14]; spearhead procedure (derived from V-Y plasty and the hourglass flap), making use of a local skin flap, drawn on the dorsal aspect of the hand [15]; V-M plasty and its modification (considered a good choice for release and reconstruction of postburn syndactyly and carried out with little complications) [16][17][18]. Sood et al [7] considers V-M plasty one of the preferred methods; V-N plasty has been noted [19]; three-squareflip-flap method is considered a simple, reliable, and safe method for treatment of postburn syndactyly [20]; dorsal rectangular scar flap [21]; four flaps' technique [22]; STAR-plasty, use of a single volar flap, harvested from each sidewall of both proximal phalanges, with 30-degree corners; method deepens and widens the web space [23]; "Seagull" flap [24]; rectangular flap from lateral finger surface [2]; cross incision plasty combined with longitudinal and transverse release [25]; dorsal rectangular flap with a single palmar triangular flap and fullthickness skin graft for palmar syndactyly [12]; scar island band rotation flap [26]; and lateral volar finger flap [27].…”