Department of Plastic Surgery, Kirkuk General Hospital, Kirkuk, Iraq


Background: Skin grafting for syndactyly repair is time-consuming, and has high potential risks of scar contracture and web creep. The dorsal island metacarpal advancement flap for web space reconstruction in syndactyly with multiple Z flaps repair eliminates the need for skin grafts. Methods: Between October 2014 to October 2017, dorsal island metacarpal advancement flap was used for web reconstruction in 26 syndactylies of 21 patients, their ages ranged from eight months to eight years. The patients were followed up for 2 to 4 years (mean: 2 years). Results: The mean operation time was 60 min (range: 50-75 min). All incisions were closed primarily without skin grafting. There were 2 partial flap necrosis, 2cases of partial wound dehiscence, 1 case of dorsal metacarpal hypertrophic scar, 2cases of contractures and one case of web creep. Conclusion: The use of dorsal island metacarpal advancement flap is reliable method for syndyctyly repair and it obviates the need for skin graft with less complication rate.