Treatment of syndactyly necessitates creation of neo-web space and separation of fingers.
Traditionally, this has been done by use of flaps taken from the dorsum; the resultant raw
areas thus created have been managed by use of skin grafts. The classical teaching has
been that the separated fingers will need skin graft as primary closure is not possible. The
skin grafts have a tendency to contract and lead to finger flexion contractures and “creep” of
the web space. We describe a flap based upon subcutaneous tissue in the web that is …

Sir, I read with great interest the article “End-of-skin grafts in syndactyly release; description
of a new flap for web space resurfacing and primary closure of finger defects” by Sharma et
al. published in Hand in 2009 [7]. The method of using an islanded dorsal flap without
additional skin grafts for syndactyly release was first described by Sherif et al. in 1998 [8],
being subsequently reported and modified by many authors [1, 3, 5, 9, 11]. While they all
agree that this method of web space reconstruction provides an excellent basis for a long …