{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T20:43:06Z","timestamp":1771188186079,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Dorsal hand skin flaps have been described in order to avoid digit skin grafting in syndactyly release. Although these skin\u2010graftless techniques present a lower rate of long term complications, they result in unsightly dorsal scarring and worse patient satisfaction. We describe a novel technique using an intermetacarpal palmar flap by performing an anatomic study and clinical application.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Ten colored\u2010latex\u2010injected fresh upper limbs were used to study the palmar cutaneous perforators to second to fourth intermetacarpal space skin flaps designed elliptical, its width extending from the center of each involved ray and measuring 40%\u201350% the length of the palm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The anatomical study revealed a mean 2.77 (range 1 to 4) cutaneous perforators originating from either the common or proper digital vessels for every intermetacarpal space and measuring 0.4\u2009mm (range 0.3 to 0.5\u2009mm) in diameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Application<\/jats:title><jats:p>This flap, measuring a mean of 21.5\u2009mm (range 20 to 23\u2009mm) in length and 9.5\u2009mm (range 9 to 10\u2009mm) in width, was used to release simple syndactylies in three patients of mean age 24\u2009months (range\u00a0=\u00a018\u201330\u2009months). After skin incision, cutaneous septa to the digital canal were released to permit flap advancement to the web space. Cutaneous perforators were not dissected. Intra\u2010operative palmar\u2010flap advancement provided commissure coverage in all children with no skin grafts needed. Over a mean follow\u2010up of 15\u2009months, no complications occurred, mean palm scar VSS was 2.4 (range 2 to 3) while it was 3 (range 3 to 3) for the commissure scars.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Skin\u2010graftless syndactyly release using a palmar intermetacarpal flap seems both reliable and easy\u2010to\u2010perform.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Therapeutic IV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.31003","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T05:40:37Z","timestamp":1673502037000},"page":"151-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pedicled palmar intermetacarpal perforator flap for skin\u2010graftless syndactyly release: Anatomical study and clinical application"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1759-9868","authenticated-orcid":false,"given":"Francisco","family":"Soldado","sequence":"first","affiliation":[{"name":"Pediatric Hand Surgery and Microsurgery Unit Barcelona University Children's Hospital HM Nens, HM Hospitales  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Cristina","family":"Garcia\u2010Martinez","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Hospital Germans Trias  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6820-3494","authenticated-orcid":false,"given":"Sergi","family":"Barrera\u2010Ochoa","sequence":"additional","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedics Deixeus Hospital  Barcelona 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