gms | German Medical Science

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

Palmar and complex distal flap in macrodactyly surgery

Meeting Abstract

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  • presenting/speaker Vladimir Zavarukhin - St Petersburg University Clinic, Saint-Petersburg, Russia

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. DocIFSSH19-1095

doi: 10.3205/19ifssh1375, urn:nbn:de:0183-19ifssh13752

Published: February 6, 2020

© 2020 Zavarukhin.
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

Text

Objectives/Interrogation: Operative treatment of macrodactyly is one of the most complex surgery. Operative technique requires the observance of a narrow "corridor" between the maximum possible resection of excess soft tissues, the shortening of the ray segments and at the same time the preservation of the blood supply of the finger.

Methods: 18 patients with macrodactyly were treated in the St. Petersburg University Clinic last 2 years. The selection criteria for this group were the enlargement of bone and soft tissues; size of affected rays were smaller or equal parent's; angulation deformyty or hyperextension in DIP joints were presented. The design of the surgery included performing the palmar flap on the digital artery from one of the side of finger and distal flar on the artery from the other side. Shortening/ angular correction/arthrodesis was used with combination of debulking. During debulking procedure distal part and free border of the palmar flap were resected.

Results and Conclusions: The presented method allowed simultaneously shortened the finger and perform circular debulking of the affected ray in all patients. Marginal necroses of the palmar flap, not exceeding 6 mm2 in area, were detected only in two patients.

The presented design of the surgery in macrodactylia allows to perform in one step shortening of the affected ray with circular debulking. This design is characterized by a low frequency and severity of complications associated with blood supply (11.1%)