Modified Three-Square-Flap for Moderate to Minor Syndactyly

ABSTRACT

PURPOSE: The main goals of correcting syndactyly of the hand are to form normal web appearance and to prevent motor dysfunction. We modified the original three-square-flap to improve interdigital web space and to reduce the wound healing problem due to tension. METHODS: From July 2005 to February 2006, three cases of moderate to minor syndactyly were treated using modified three-square-flap. These flaps were made in such as way that the A flap from dorsal side, the B flap from the interdigital surface, and the C flap from the volar side. We modified the design of dorsal A flap as a hourglass shape instead of square shape to make normal hourglass shaped interdigital web and to reduce the tension of closure with other two flaps(B and C flap). The B and C flap were made as square shape. RESULTS: During 4 to 10 months follow-up period, acceptable esthetic results were obtained without any specific complication, using our modification of the three-square-flap. CONCLUSION: Our method showed more satisfactory web appearance and was safe to use even in the cases of syndactyly secondary to burns and post- traumatic scars because of excellent blood circulation.