Application of bell-bottom flap for reconstruction of the web space in the fifth and fourth toe polysyndactyly
10.3760/cma.j.cn114453-20201231-00656
- VernacularTitle:Bell-bottom皮瓣在足部小趾多趾伴第4、5趾并趾畸形治疗中的应用
- Author:
Minjian CHEN
1
;
Yong SONG
;
Yi WANG
;
Baiye CHEN
Author Information
1. 福建医科大学附属福建省妇幼保健院整形外科，福建省妇儿重大疾病研究重点实验室，福州 350001
- Keywords:
Polydactyly;
Syndactyly;
Foot;
Bell-bottom flap
- From:
Chinese Journal of Plastic Surgery
2021;37(9):981-986
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of the bell-bottom flap in the treatment of multiple little toes with syndactyly deformity of the 4th and 5th toes.Methods:Forty cases (22 males and 18 females) of multiple little toes with syndactyly deformity of the 4th and 5th toes were treated in the Plastic Surgery Department of Fujian Maternal and Child Health Hospital from June 2014 to May 2020. The age of patients ranged from 6 months to 36 months, with an average of 11 months. There were 46 feet, among which 19 cases had a complete fusion, and 27 cases had an incomplete fusion. During the operation, the polydactyly was removed, the fibula-deviation deformity of little toes was corrected with the articular surface formation and joint capsule repaired. The bell-bottom flap was used to reconstruct the webbed of the toe, and the wound surface on the side was closed with three flaps made up of the residual skin soft tissue of multiple little toes. Meanwhile, the soft tissue length at the distal end of the little toe was extended, and the toenail fold and palmar flexion transverse lines were reconstructed to form a similar appearance to the normal.Results:All the flaps in all 46 feet survived with no flap necrosis, skin grafting, or infection. After 6 to 36 months of follow-up (averagely, 20 months), the width, depth, and slope of the reconstructed toe webbed were normal or close to normal, the fibula deviation of the small toe was corrected entirely, the deformity of the short toe was improved in varying degrees, no toe scar contracture, and the appearance of nail fold was consistent with that of the normal small toe.Conclusions:Bell-bottom flap is a good method to correct the deformities of small toe polysyndactyly, which can reconstruct the well-formed webbed, no skin grafting, with the shape of small toenail fold and small toe naturally, and the radians of palmar flexion line naturally.
