Treatment of Webbed Fingers. Syndactylism

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Probably the most generally adopted method of treating syndactylia is that suggested by Didot which consists of incisions on the volar and dorsal sides of the involved fingers. The flaps of skin are raised, leaving their bases laterally on opposite sides. When the flaps are sufficiently freed, they are sutured to the skin at the middle of the volar side on one finger and at the middle of the dorsal side on the other. The greatest difficulty consists in obtaining a sufficient amount of skin and it has been my experience that, to obtain a complete covering, many difficulties are encountered.

It is my impression that these can best be handled by means of free full thickness or thick split grafts obtained from the thigh as illustrated in the following case:

The child, 2 years of age, had syndactylism involving the middle and ring fingers of both hands. The method of treatment is demonstrated only for the right hand, a similar procedure being adopted for the left. Figure 1, A and B, shows the webbing of the ring and middle fingers prior to operation.

Under avertin and gas anesthesia, the web between the involved fingers was completely divided, the incision being carried well back in order to form a normal fold at the base of the fingers. A thick split graft was then procured from the thigh and it was further prepared by making multiple holes in it with a sharp bistoury knife, to permit the escape of any serum. . .



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