Single-Stage Reconstruction of Congenital Multifinger Syndactyly with Contiguous Cross-Shaped Advancement Flaps
Bibliographic record
Abstract
BACKGROUND: The authors report the techniques and results of contiguous dorsal cross-shaped advancement flaps for reconstruction of 3- or 4-finger syndactyly in a single-stage operation for congenital syndactyly. METHODS: Thirty-five patients with multiple-finger syndactyly who received webspace reconstruction using the contiguous dorsal cross-shaped advancement flaps in a single operation were retrospectively studied. The patients ranged in age from 5 to 96 months (average age, 29.6 months). The contiguous dorsal cross-shaped flaps were advanced to reconstruct both webspace and lateral walls of the bases of the conjoined fingers. Withey grading was used for postoperative evaluation of web creep. Scar hyperplasia was assessed using the Vancouver Scar Scale. A visual analog scale of 0 to 10 was applied to evaluate the subjective satisfaction of the parents. RESULTS: In all cases, the syndactyly was successfully released in a single operation. There were no perioperative complications in this group. During a 12- to 58-month follow-up period, all reconstructed webspaces exhibited satisfactory appearance, and there was no obvious web creep. The dorsal hand scars were acceptable. Revision surgery was not needed in any patient. The average web creep was 0.45, and the average Vancouver Scar Scale score was 1.6. The average visual analog scale score for appearance was 1.2, and that for function was 2.5. CONCLUSIONS: Multiple syndactyly release in 1 stage is feasible and safe. The contiguous cross-shaped flaps can be used to reconstruct 2 or more webspaces simultaneously after releasing. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".