Document Detail


STARplasty for reconstruction of the burned web space: introduction of an alternative technique for the correction of dorsal neosyndactyly.
MedLine Citation:
PMID:  15725834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Significant hand burns frequently result in dorsal neosyndactyly, despite appropriate wound care, excision/grafting, and occupational therapy. Patients often develop limited abduction, tethered flexion/extension, intrinsic tightness, and inversion of the web space. We present a new technique for neosyndactyly release: the STARplasty (Syndactyly Treatment After Release), named after the appearance of the reconstructed web. METHODS: We performed a retrospective review of 25 patients who underwent 66 web space reconstructions by a single surgeon, from January 2002 to December 2003. The STARplasty was developed prior to the study period, with the following goals: to use local tissue, negate the need for a skin graft, and permit early range of motion. Combined with longitudinal, transverse, and oblique releases, STARplasty uses a single volar flap, harvested from each sidewall of both proximal phalanges, with 30-degree corners. STARplasty simultaneously deepens and widens the web space while correcting the angle of inclination. RESULTS: Sixteen patients (mean age: 34 years; range: 3-62 years) underwent a total of 33 STARplasties, an average of 37 months after burn injury. Mean area resurfaced per web was 5.2 cm, which contrasts with the 33 non-STARplasty reconstructions, which were used to resurface a mean area of 19.4 cm (P < 0.05) and included 5-flap z-plasties (17), full-thickness skin graft (10), 2-flap z-plasties (3), and advancement flaps (3). No complications occurred in the STARplasty group, including infection, flap loss, dehiscence, nerve injury, or recurrent contracture. All patients had improved function (mean follow-up: 6.7 months; range: 1-18 months). CONCLUSIONS: STARplasty is a new, safe, and efficacious technique to correct dorsal neosyndactyly and reconstruct the web space after burn injury.
Authors:
C Scott Hultman; Sumeet Teotia; Catherine Calvert; Sydney Thornton; Jennifer Schram
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  54     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-23     Completed Date:  2005-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  281-7     Citation Subset:  IM    
Affiliation:
Division of Plastic and Reconstructive Surgery, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7195, USA. cshult@med.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Burns / surgery*
Child
Child, Preschool
Female
Finger Injuries / surgery*
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies
Reconstructive Surgical Procedures / methods*
Retrospective Studies
Syndactyly / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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