Optimizing Surgical Outcomes in Congenital Syndactyly: Evaluation of Flap and Graft Techniques in Older Pediatric Patients.

Background Congenital syndactyly is a common congenital hand anomaly that impairs daily activities and impacts both functional and aesthetic outcomes. The fusion of adjacent fingers limits functionality and often requires surgical intervention to restore web spacing, maintain function, and improve appearance. This study evaluates surgical outcomes of congenital syndactyly treatment using flap and graft techniques, focusing on older patients. Methodology This study utilized retrospective data collected from patients aged 2 to 12 years diagnosed with congenital syndactyly. These patients underwent surgical separation procedures employing various flap techniques and full-thickness skin grafts. The chosen methods aimed to minimize scarring, secure optimal blood supply, and reduce postoperative complications. Postoperative assessments included web spacing, aesthetic appearance, and functional recovery. Results Patients generally experienced improved web spacing and proper alignment, with minimal contracture post-surgery. Flap and graft techniques effectively reduced visible scarring and provided favorable cosmetic results. Functional recovery was significant, allowing patients to resume age-appropriate tasks with minimal limitations, thereby restoring confidence in daily activities. Despite not undergoing early surgery, older patients still achieved marked improvements in web spacing, aesthetics, and overall function. Conclusions Surgical treatment of congenital syndactyly using flap and graft techniques significantly enhances both functional and aesthetic outcomes, even when the intervention is delayed beyond the recommended early age. Comprehensive planning and tailored approaches are crucial to achieving optimal web spacing, minimized scarring, and restored hand function. These measures ultimately improve the quality of life for patients, regardless of age at the time of surgery.

Management of Pediatric Supracondylar Humerus Fractures Using Lateral Cross-Wiring Technique Under Fluoroscopic Guidance.

BACKGROUND:  Supracondylar humeral fractures are the most prevalent elbow fractures in pediatric patients. Current treatment modalities typically involve closed reduction and fixation using percutaneous Kirschner wires. The lateral cross-wiring technique has demonstrated favorable functional and cosmetic outcomes, thereby reducing the incidence of ulnar nerve injury. OBJECTIVES:  This study aimed to assess the efficacy of the lateral cross-wiring technique in achieving optimal functional and cosmetic recovery while mitigating the risk of ulnar nerve injury in pediatric patients with displaced supracondylar humeral fractures. MATERIALS AND METHODS: A prospective analysis was conducted on 48 patients who underwent lateral cross-wiring for displaced supracondylar fractures (Gartland type III, including extension and flexion types) of the humerus. Follow-up assessments were performed over a minimum period of eight months post-surgery. RESULTS: Among the 48 patients, all demonstrated satisfactory restoration of the carrying angle and functional ability postoperatively. Notably, no iatrogenic cases of radial or ulnar nerve injury were observed during the follow-up period. CONCLUSION:  The lateral cross-wiring technique emerges as an effective treatment option for displaced supracondylar fractures of the humerus in pediatric patients. It facilitates both functional and cosmetic recovery while concurrently reducing the risk of ulnar nerve injury, thus warranting consideration in the management of such fractures.