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Syndactyly Correction Using a Venous Flap With the Plantar Cutaneous Venous Arch

Sakamoto, Natsuki MD; Matsumura, Hajime MD, DMSC, FACS; Komiya, Takako MD; Imai, Ryutaro MD; Niyaz, Ahmatjan MD; Watanabe, Katsueki MD

doi: 10.1097/SAP.0b013e31826a1d1d
Hand Surgery

Abstract: A combination of skin grafts and local flaps is widely used in the reconstruction of syndactyly of the toes. Covering the skin defect without skin grafts on the unilateral side of the toe is preferred, and for this purpose, a rotated flap from the plantar area is typically used. However, the flap can become ischemic or congested in some cases. To avoid this, we elevated a plantar flap with the plantar cutaneous venous arch using a triangular venous flap and covered the lateral side of the web in 7 cases of syndactyly. The dorsal flap was used to create the new web, and the opposite lateral side was reconstructed using a skin graft. The flap circulation was stable, the pedicle of the flap was narrow, and the flap relocation was simple. No flap in any patient showed any evidence of congestion or ischemia. Follow-up demonstrated that the new web was patent in all cases, with no evidence of contraction.

From the Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.

Received March 11, 2012, and accepted for publication, after revision, July 16, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Hajime Matsumura, MD, DMSC, FACS, Department of Plastic and Reconstructive Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. E-mail: hmatsu-tki@umin.ac.jp.

© 2014 by Lippincott Williams & Wilkins