A new surgical procedure for little toe polysyndactyly without skin graft.

We developed a new operative procedure involving the combination of 5 flaps to treat little toe polysyndactyly. We applied this procedure to 4 toes of 3 patients who had severe polysyndactyly involving skin fusion of the area from the distal interphalangeal joint to the periphery. In all 3 patients, this procedure allowed easy transfer of the flaps, caused no tension to the wound during skin suturing, and did not disrupt blood flow through the flap. The morphology of all 4 toes was favorable, and no scarring was evident. A sufficiently deep fourth interdigital space was created with this procedure without the need for skin grafting.