gms | German Medical Science

Objectives/Interrogation: Web creep is the most common complication after syndactyly separation. We developed a novel orthosis which can exert consistent pressure on web and incision scar postoperatively. The orthosis is applied with silicone sheet simultaneously. The study was to evaluate the aesthetic and functional outcomes using this novel orthosis to control web creep.

Methods: A total of 71 patients underwent syndactyly separation in past 10 years were included in the study. Among these patients, 40 patients used the novel orthosis, while 31 cases used traditional splinting and scar massage postoperatively. We assessed the height and width of the webs according to the criterion of D'Arcangelo, and total active digital motion compared with the normal side. Scar formation was measured by the Vancouver Scar Scale score. We also administered a parent-based satisfactory questionnaire.

Results and Conclusions: The mean follow-up period was 4.5 years. The height and width of 36 webs were good, 3 webs were fair, and 1 web was poor in the group using the novel orthosis, while 13 webs were good, 10 webs were fair, and 8 webs were poor in the group using the traditional method. Mean total active motion of the index, middle, ring, and little fingers of the affected side was 160, 158, 153, and 150 in orthosis group, respectively, which was significantly greater than those in traditional group. Mean Vancouver Scar Scale score was 1.4 in orthosis group, which was better than that in traditional group with the score of 3.1. All parents were satisfied with the appearance and function of the fingers in orthosis group. In conclusion, applying the novel orthosis was a reliable method to control web creep and restore hand function for patients with syndactyly separation.