A Novel ‘Starfish’ Flap for Syndactyly Release: Technique and Early Results

Background/Purpose: Multiple incisions and flaps have been designed for congenital syndactyly release. Despite advances in synthetic dermal substitutes, graftless surgery has been advocated to decrease scarring, surgical time, and perhaps improve cosmesis. Dorsal skin rearrangement is the most common technique to add vascularized flaps to the release. We describe a novel technique, using a ‘starfish’ dorsal commissure flap, which incorporates a z-plasty advancement of the lateral commissure leaving transverse scars over the metacarpophalangeal (MCP) joints along Langer’s lines. Methods: The ‘starfish’ flap presented here is designed with a dorsal star …