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Basic Principles of Surgical Treatment and Postoperative Management of Syndactyly

This lecture covers the core principles of treating congenital syndactyly of the hand, with attention to when to operate, how the approach changes with simple, complex and syndromic forms, and how surgical planning influences long-term function and appearance.

Particular emphasis is placed on Brunner-type zigzag incisions, creation of the interdigital web space, protection of digital neurovascular structures, and the role of full-thickness skin grafts when local tissue is insufficient. The lecture also addresses donor-site selection and a practical method for sizing grafts.

The most distinctive part is the postoperative strategy. The discussion explains why immobilization in a young child is not simply a dressing issue, how the hand and elbow are positioned, why routine early dressing changes may be avoided, and which complications can lead to recurrent deformity or revision surgery. Clinical examples of complex syndactyly, congenital webs and associated anomalies add context to the surgical principles.

PRAS-04

Course

Upper Extremity and Hand Reconstruction: From Congenital Anomalies to Complex Trauma

01 45:14 Reconstruction of Post-Traumatic Tissue Defects of the Upper ExtremityA practical lecture on staged reconstruction after severe upper-limb war trauma: soft-tissue coverage, bone defects, nerve repair, fixation timing, microsurgery, and case-based decision-making.

02 54:36 Now playing Basic Principles of Surgical Treatment and Postoperative Management of SyndactylyA practical overview of syndactyly surgery, from timing and incision design to full-thickness skin grafting and the often underestimated challenge of postoperative immobilization in young children.

03 1:02:11 Surgical Restoration of Thumb OppositionA focused lecture on restoring thumb opposition after nerve injury and complex hand trauma, with a practical comparison of tendon and muscle transfer techniques.

04 1:03:36 Replantation Surgery: Experience, Decision-Making and Practical AlgorithmsA practical look at replantation surgery built around real clinical cases, from patient selection and correct transport of amputated segments to microsurgical reconstruction, salvage strategies and staged rehabilitation.

05 1:42:12 Microsurgical Reconstruction of the Upper Extremity in a Level 1 Trauma CenterA practical look at complex upper-extremity trauma reconstruction, from aggressive debridement and limb-salvage decisions to free flaps, nerve grafts, flow-through flaps and functional rehabilitation.

06 1:40:27 The Role of Hand Therapy in Restoring Upper Limb Function After Trauma and SurgeryA practical introduction to hand therapy and the often underestimated role of edema management in protecting motion, preventing stiffness, and improving recovery after hand trauma and surgery.

07 1:05:39 Spaghetti Wrist Injury: Repair Strategy, Microsurgery and RehabilitationA practical lecture on complex volar forearm injuries involving multiple tendons, nerves and arteries—from injury mechanism and operative sequencing to microsurgical repair, immobilization and long-term hand rehabilitation.

08 1:31:56 Toe Transfer for Thumb and Finger ReconstructionAn advanced lecture by Prof. Fu-Chan Wei on toe-to-thumb and toe-to-finger transfer in complex hand reconstruction, including indications, surgical planning, technique selection, functional outcomes, donor-site considerations, and rehabilitation.

09 1:32:17 Management of Gunshot Injuries to Peripheral NervesAn evidence-informed lecture on diagnosing and reconstructing gunshot peripheral nerve injuries in polystructural limb trauma. Andrii Vysak combines a treatment algorithm, clinical cases, and practical decisions on timing, ultrasound, EMG, nerve grafting, and tendon transfers.