THE USE OF TISSUE EXPANDERS IN SYNDACTYLY REPAIR

The syndactyly repairs of 11 hands in seven patients (average age 20.4 ) who had simple complete syndactyly between the third and fourth fing ers were done by the use of tissue expanders in order to obtain adequa te skin closure. At the first stage, a wedge type, 7 cc tissue expande r was placed beneath the dorsal skin of the syndactylous digits via a vertical dorsal hand incision under local anesthesia. Inflation was be gun on the 15th postoperative day. After the inflation period (average 32 days), syndactyly repair similar to the Littler technique was perf ormed using axillary block anesthesia. During the expansion period one tissue expander became exposed and this band was repaired by the clas sical skin grafting technique. In the remaining ten hands the expanded dorsal skin ensured skin closure of the digits and web reconstruction without any need for skin grafting. No complications were encountered during the postoperative period. Active and passive abduction angles, tip-to-tip length, active range of motion of the digits, and two poin t discrimination tests were done at follow-up (average six months). Th e web appearances were normal in all patients. Active abduction angles and active range of motion of the digits was always normal at the thi rd postoperative month. Two point discrimination was 8.7 mm on the int erdigital sides of the digits and there was no tip-to-tip length diffe rences of the digits. No contractures were seen.