Flashcards on Pediatric Congenital Hand Deformities
Pediatric Congenital Hand Deformities: Analysis for Students
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Syndactyly surgical management
107 cards
Card 1
Question: What anesthesia and equipment are preferred for syndactyly release surgery?
Answer: General anesthesia, a tourniquet, and loupe magnification.
Card 2
Question: Which flap is preferred for reconstruction of the web (commissure) in syndactyly release?
Answer: A dorsal commissure flap.
Card 3
Question: Describe the typical design and extent of the dorsal commissure flap.
Answer: It begins at the level of the metacarpal heads and extends two thirds of the length of the proximal phalanx; a rectangular palmar flap is made on its
Card 4
Question: How are interdigitating flaps constructed distal to the commissure flap?
Answer: Interdigitating zigzag dorsal and palmar flaps are made: the dorsal zigzag starts at one distal corner of the commissure flap and extends to mid-PIP,
Card 5
Question: Why are the palmar zigzag and dorsal flap bases centered over opposite PIP and DIP joints?
Answer: This orientation minimizes flexion scar contracture and maximizes coverage potential by allowing proper interdigitation.
Card 6
Question: Why is the palmar rectangular flap often biased to cover one digit entirely?
Answer: To require fewer skin grafts and less operative time, accepting residual bare areas on the adjacent digit that will need grafting.
Card 7
Question: What key structures must be preserved when elevating the dorsal flaps?
Answer: The paratenon surrounding the extensor tendon.
Card 8
Question: What is the sequence of flap elevation and dissection during syndactyly separation?
Answer: Dorsal flaps are elevated first (preserving paratenon), then palmar flaps are raised and neurovascular bundles isolated; digits are separated distal t
Card 9
Question: How does manual spreading of the digits assist during separation?
Answer: It places intervening tissue under tension, facilitating separation of the digits.
Card 10
Question: What is done with sturdy transverse fascial bands encountered during proximal dissection?
Answer: They are excised to allow sufficient proximal placement of the commissure.