ABSTRACT
Syndactyly is one of the most common congenital hand deformities. Web space reconstruction is an important component of syndactyly treatment. Our objective is to evaluate the method of web space defect closure in syndactyly repair, using a V-Y dorsal metacarpal advancement flap, without using skin grafts. Over the period of six years [May 2003 through May 2009], a total of 20 patients [24 hands, 25 web spaces] with simple syndactyly were operated upon using a dorsal metacarpal skin flap based on a direct coetaneous branch of the dorsal metacarpal artery. This flap was advanced in a V-Y fashion to aid in web space defect closure, without using skin grafts. There were 15 males and five females. Four cases had bilateral, three had right sided and the remaining 13 had left sided syndactyly. Fourteen cases had complete type and six had incomplete type. The mean age at operation was 4.7 years [range 1-12]. The web spaces affected were the thumb-index, middle-ring, ring-little in one, 18, and six web spaces respectively. The mean follow up period was 10 months [range 6-35 months]. All patients had uneventful postoperative period. There was no flap necrosis or digital vascular compromise. One case showed hypertrophic scarring of the repair but all patients had acceptable range of motion at follow up. Dorsal metacarpal skin flap advancement is a good way of repairing the web space defect during syndactyly release, eliminating the need for skin grafts
ABSTRACT
Auricular burn is a common injury encountered in the burn patients. It has devastating complications including chondritis, hypertrophic scars and hyperpigmentation, the worse of which is chondritis inevitably leading to deformity. The study shows our experience in prevention, early detection and proper management of auricular burn and chondritis. A retrospective descriptive study. This study was conducted at the Royal Rehabilitation Centre, King Hussain Medical Centre, Jordon from January 2000 to December 2005. All the patients admitted to the burn unit at the Royal Rehabilitation Center at King Hussein Medical Center from January 2000 through December 2005 with burn involving the ear were included in the study. The ears were managed locally with topical antibiotics and light pressure dressing. Early detection of chondritis was undertaken and early management with surgical intervention and proper dressing was applied. A total of 62 patients [11.5%] out of 537 had ear burn, 71% were due to direct flame burn. Chondritis developed in 10.8% of patients with deep superficial and full thickness direct flame burned ears. Twelve and half percent of ears were lost, 25% had mild deformity, and 62.5% of ears developed moderate deformity. Hyperpigmentation occurred in 21.6% of ears and 9.5% developed hypertrophic scars. Chondritis is a devastating complication after auricle burn. The incidence of chondritis can be decreased by proper care of the burned ear and avoidance of infection. Early detection and proper management of this condition can decrease the severity of deformity as sequelae of chondritis