Simple Syndactyly Release With Dental Roll Dressing

The goal of surgical intervention to repair syndactyly is to improve cosmesis and allow for a fully functional hand with independent finger motion while preventing web creep, angular deformity of the involved digits, soft tissue contracture, or neurovascular injury. Because web creep is one of the most common complications of commissure reconstruction, it is important to create a good dorsal flap with a broad insertion proximal to the commissure. The authors describe a technique in which the placement of a "dental roll" between the newly separated digits helps not only with graft take and to seat the dorsal flap well into the web space, but also to prevent the newly separated digits from touching each other. The use of the dental roll in the web space is novel, can be used in place of standard bolter-type dressings, and, along with the creation of an appropriately sized dorsal commissure flap, has the potential to enhance healing and perhaps prevent web creep.