Three-square-flip-flap reconstruction for post burn syndactyly

Burns of the hands may result in the formation of web space contractures—post burn syndactyly. We present our experience using the three-square technique originally described by Bandoh for minor syndactyly. Method Tissues of the contracted web are regard as forming three facets of a cube. If elevated and transposed 90° on their base the facets will fall into place and line the interior of the cube creating a deepened web-space. The first flap is based on the web itself either dorsally or volarly. The second flap is based distally on one of the fingers. The third flap is based laterally on the other finger. Surgery is followed by a splinting regimen. Results The design of the flaps is simple and the operation is easy to perform. This technique has achieved good functional and cosmetic results; there have been no flap losses or significant complications. Conclusion The three-square-flip-flap is a simple reliable and safe method for the treatment of post burn syndactyly.