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Journal of Hand Surgery (British and European Volume)
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An Experience of the Snow–Littler Procedure

M. A. RIDER
S. I. GRINDEL
M. A. TONKIN
V. E. WOOD

From the University of Sydney and the Department of Hand Surgery, Royal North Shore Hospital, Sydney, Australia and the Department of Orthopaedic Surgery, Loma Linda University School of Medicine, California, USA

This paper reviews the results of the Snow–Littler procedure performed in twelve hands with classical central longitudinal deficiency and in one hand with symbrachydactyly, cleft type. There were no instances of major flap necrosis although two flaps showed tip ischaemia. The width of the first web was, in the main, satisfactory but four webspace revisions were performed. Supplementary skin grafting at the time of surgery was necessary in complete and/or complex thumb index syndactylies and in the patient with symbrachydactyly. In eight cases, a transverse metacarpal ligament was reconstructed. In the five other cases, no clinical instability or radiological divergence of the index and ring fingers occurred, in spite of no transverse metacarpal ligament reconstruction. Three de-rotational osteotomies of transposed index fingers were performed in patients who had a transverse metacarpal ligament reconstruction. These results indicated significantly improved appearance and improved function following the Snow–Littler procedure.

Journal of Hand Surgery (British and European Volume), Vol. 25, No. 4, 376-381 (2000)
DOI: 10.1054/jhsb.2000.0447
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