Reconstruction of Multiple Digital Defects by Temporary Syndactylization Using a Lateral Arm Free Flap

Abstract

Background Soft tissue defects of the multiple finger present challenges to reconstruction surgeons. Here, we introduce the use of a lateral arm free flap and syndactylization for the coverage of multiple finger soft tissue defects.

Methods This retrospective study was conducted based on reviews of the medical records of 13 patients with multiple soft tissue defects of fingers (n = 33) that underwent temporary syndactylization with a microvascular lateral arm flap for temporary syndactylization from January 2010 to December 2020. Surgical and functional outcomes, times of flap division, complications, and demographic data were analyzed.

Results Middle fingers were most frequently affected, followed by ring and index fingers. Mean patient age was 43.58 years. The 13 patients had suffered 10 traumas, 2 thermal burns, and 1 scar contracture. Release of temporary syndactyly was performed 3 to 9 weeks after syndactylization. All flaps survived, but partial necrosis occurred in one patient, who required a local transposition flap after syndactylization release. The mean follow-up was 15.8 months.

Conclusion Coverage of multiple finger defects by temporary syndactylization using a free lateral arm flap with subsequent division offers an alternative treatment option.

Keywords

soft tissue defects - multiple defects - traumatic injury - amputation - free flap

Availability of Data and Materials

Data were obtained from medical records, in strict accordance with the privacy policy and ethical code of our institute.

Ethical Approval and Consent to Participate

The study involved standard treatment regimens and approved by the Institutional Review Board (IRB NO. 2022–03–040). All procedures were performed after obtaining informed consent from all patients. The study was performed in accordance with the Declaration of Helsinki.

Patient Consent

Patients provided written informed consent for the publication and the use of their images.

Authors' Contributions

Sae Hwi Ki conceptualized the study. Tae Jun Park and Jin Myung Yoon were involved in data curation. Tae Jun Park and Jin Myung Yoon contributed to investigation. Sae Hwi Ki supervised the study. Sae Hwi Ki and Choi MSS were involved in writing—original draft. Choi MSS and Min Ki hong contributed to writing—review and editing.

Financial Support and Sponsorship

None.

Publication History

Received: 14 April 2022

Accepted: 22 July 2022

Accepted Manuscript online:
07 September 2022

Article published online:
13 December 2022

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