Release of Partial Syndactyly Using a Trident Flap Without Skin Grafting

We reviewed outcomes of a modified trident flap technique in 83 patients for a series of partial syndactyly releases performed by a single operator over 30 years. Only patients with at least 3 years of follow-up (range 3 to 27 years) were included. One-hundred and twenty-seven procedures were performed for 83 patients, and no cases of flap necrosis occurred. Three hands had Grade 1 web creep on Withey’s semi-quantitative scoring system, and two had Grade 2 web creep. Revision surgery was required for one minor contracture and one intermediate contracture. Abduction angles of up to 30° were measured for operated adjacent fingers. The mean satisfaction score of the child or parents on the visual analogue scale was 1.1. The trident flap is a safe procedure, with excellent functional and cosmetic outcomes. The residual scarring is limited to the web, and there is no scarring on the dorsum of the hand. Level of evidence: IV