Comparative study between Hexagonal and Rectangular Flaps for Web Reconstruction of Simple Syndactyly of the Fingers

Background: Syndactyly is a common congenital hand anomaly, affecting one in every 2000 live births, and can be classified as complex, simple, complicated, or syndromic. Syndactyly release is one of the most frequent procedures in congenital hand operation. Aim and objectives: To review different modalities for the release of simple congenital syndactyly and assess the hexagonal advancement flap and the rectangular flap in web reconstruction in desyndactyly procedures. Patients and methods: This prospective research involved twenty cases of simple congenital syndactyly admitted to the Department of Plastic & Reconstructive Surgery at Al Azhar University hospitals. Cases were separated into two groups according to the surgical procedure: Group A treated ten cases with rectangular advancement flaps, and Group B treated ten with hexagonal advancement flaps. Results: The two groups showed insignificant differences in terms of degree of syndactyly, localization, web creep, flexion contracture, and need for a second operation, while there were significant differences in terms of operative time (hours). There were 90% of patients with complete grafts and 10% with partial grafts. Conclusion: Hexagonal and rectangular advancement flaps are good ways to release simple and complex syntactically. They have benefits like being easy to learn, changing during surgery, and having wide tips that keep flap tips from necrosis.