Surgery Spotlight: Bilateral Syndactyly Reconstruction-Surgery Spotlight: Bilateral Syndactyly Reconstruction

Surgery Spotlight: Bilateral Syndactyly Reconstruction

Video Transcription

Video Summary

In a video lecture by Kevin Chung from the University of Michigan, the focus is on congenital hand reconstruction for a child with complex bilateral syndactyly. This intricate surgical procedure involves separating conjoined fingers, specifically a complete syndactyly on one hand, where bony components in the distal phalanx are fused. Dr. Chung emphasizes the importance of creating a long dorsal skin flap to prevent web space scarring and subsequent finger adhesions. The technique includes the use of zigzag incisions to create flaps that resurface the fingers' sides. In cases where skin is short, a skin graft, typically harvested from the groin area to minimize visible scarring, is necessary. The goal is to ensure the web space is properly reconstructed and prevent contractures. Dr. Chung details the meticulous steps, including managing skin flaps, ensuring proper vascular supply, and sewing techniques, to ensure successful separation of the fingers and reconstruction. Post-operative care involves immobilizing the hand with a cast for several weeks to ensure proper healing and graft adherence, minimizing complications and allowing for future functional use of the hand.

Asset Caption

In this video, Kevin Chung, MD performs a release on a two-year-old child born with complex bilateral syndactyly between the long and middle finger. It is a complex syndactyly because it involves the bony components of the distal phalanx being stuck together. In this video, Dr. Chung demonstrates the proper marking technique for planning the surgery, as well as how to utilize zigzag incisions to create the appropriate flap design. He discusses the most appropriate skin graft donor site and why the most important element of the surgery is the long dorsal skin flap to resurface the web space. He also describes a refinement on the closure technique that he has previously documented in textbooks.

Surgeon Kevin Chung, MD

Disclosure Dr. Chung has nothing to disclose. Dr. Neumeister has a Board of Trustee relationship with MTF Musculoskeletal Transplant Foundation. Dr. Aly is a consultant, speaker and advisor for Ethicon/J&J; receives research support from Ethicon/J&J; is an advisor for Angiotech Pharamceuticals; is an advisor for and a shareholder with Incisive Surgical Inc.; and receives royalties from QMP. All ASPS staff members managing this activity have no relevant financial relationships or affiliations to disclose. All identified conflicts of interest have been resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity, and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials. This product is not certified for CME.

Keywords

surgery spotlight

Surgical Videos

Hand

Nerve

Kevin Chung MD; Memben

congenital hand reconstruction

bilateral syndactyly

dorsal skin flap

zigzag incisions

skin graft

web space reconstruction

post-operative care