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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Application of vascular grafting in syndactyly release of Poland syndrome

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  • presenting/speaker Xiaofang Shen - Wuxi N0.9 People Hospital, Wuxi, China

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1020

doi: 10.3205/19ifssh0523, urn:nbn:de:0183-19ifssh05237

Published: February 6, 2020

© 2020 Shen.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Poland syndrome includes the deformity of brachysyndactyly. The etiology of Poland syndrome may be related to the development of the subclavian artery of the fetus at the sixth week of pregnancy. Some patients with Poland syndrome have higher position of palmar digital arteries bifurcation points. In the separation of fingers, the side finger artery is often ligated to obtain the deep web shape and hand function.The purpose of this study was to investigate the effect of superficial dorsal palmar vein grafting on lengthening the unilateral digital artery and deepening the finger web.

Methods: 1. age <3 years old; 2. Poland syndrome hand deformity manifested as 2-5 fingers brachysyndactyly. 3. higher position of palmar digital arteries bifurcation points were found during the separation. From June 2014 to December 2017, a total of 5 patients were treated with palmaro-dorsal superficial vein transplantation to extend the lateral digital artery and deepen the digital webbed. Postoperative follow-up was conducted to observe the depth and morphology of the fingers web.

Results: The operation was successfully completed, all the flap and skin grafting were completely alive, and there were no early complications such as infection and skin necrosis. All patients were followed up for 7-27 months, with an average of 14.3 months. All patients had a reconstruction depth of digital webbed at nearly 1/3 of the proximal phalanx, 5-7mm deeper than the position of palmar digital arteries bifurcation points, with an average of 6.12mm. Both the appearance and function were satisfactory without conspicuous scar.The depth, width and slope of the webbed are normal without conspicuous scar.

Conclusion: Using palmaro-dorsal superficial vein transplantation to extend the lateral digital artery and deepen the digital web can not only retain the two digital arteries but also have no additional incisions. The operation of vascular transplantation is simple and the clinical learning cycle is short, so it is suitable for clinical promotion.