A Comparative Study of Dorsal Flap Geometries in Syndactyly Repair
Location
Ada, Ohio
Start Date
9-12-2025 2:50 PM
End Date
9-12-2025 3:00 PM
Description
Syndactyly, a common congenital malformation resulting from incomplete separation of adjacent digits, often requires reconstructive surgery to divide fused tissues and re-establish a functional web space. Successful web commissure reconstruction depends heavily on the geometry of the dorsal flap, which must create a 45–50° dorsal–palmar slope and adequately cover the proximal phalanx. Although various flap designs—such as rectangular, hexagonal, and pentagonal—are widely used, their selection is typically based on surgeon preference rather than quantitative biomechanical evidence. Postoperative complications, including contracture, reduced mobility, scarring, joint instability, and web creep, are closely related to stress concentrations within the reconstructed commissure. However, despite their clinical significance, the mechanical implications of flap size and geometry have not been systematically studied. This work presents a numerical investigation into how dorsal flap design influences stress distribution in simple syndactyly reconstructions. Using a high-fidelity finite element hand model, we evaluated three commonly used flap geometries—rectangular, hexagonal, and cross-shaped—and quantified maximum stresses. Because skin mechanical properties vary with patient age, these age-dependent changes were incorporated into the simulations. The results demonstrate clear trends linking flap geometry to local stress levels.
Recommended Citation
Kottmyer, Colleen, "A Comparative Study of Dorsal Flap Geometries in Syndactyly Repair" (2025). College of Engineering Student Research Colloquium. 17.
https://digitalcommons.onu.edu/eng_student_research_colloquium/2025/Presentations/17
A Comparative Study of Dorsal Flap Geometries in Syndactyly Repair
Ada, Ohio
Syndactyly, a common congenital malformation resulting from incomplete separation of adjacent digits, often requires reconstructive surgery to divide fused tissues and re-establish a functional web space. Successful web commissure reconstruction depends heavily on the geometry of the dorsal flap, which must create a 45–50° dorsal–palmar slope and adequately cover the proximal phalanx. Although various flap designs—such as rectangular, hexagonal, and pentagonal—are widely used, their selection is typically based on surgeon preference rather than quantitative biomechanical evidence. Postoperative complications, including contracture, reduced mobility, scarring, joint instability, and web creep, are closely related to stress concentrations within the reconstructed commissure. However, despite their clinical significance, the mechanical implications of flap size and geometry have not been systematically studied. This work presents a numerical investigation into how dorsal flap design influences stress distribution in simple syndactyly reconstructions. Using a high-fidelity finite element hand model, we evaluated three commonly used flap geometries—rectangular, hexagonal, and cross-shaped—and quantified maximum stresses. Because skin mechanical properties vary with patient age, these age-dependent changes were incorporated into the simulations. The results demonstrate clear trends linking flap geometry to local stress levels.