The Application of a Cross-Shaped Advancement Flap in Polysyndactyly of the Fifth Toe

Polysyndactyly of the foot is a common congenital malformation of the lower extremity. We introduce our surgical technique for reconstruction of polysyndactyly of the fifth toe fused with the fourth toe. The technique includes the removal of the medial hypoplastic ray, web-space reconstruction using a dorsal cross-shaped advancement flap and closure of the lateral incisions of the separated toes with a tongue-shaped flap and zigzag triangular flaps. This technique is advantageous to prevent postoperative web creep, reduce the tension of the dorsal incision closure and it is relatively easy to grasp for the inexperienced surgeon. <b>Level of Evidence:</b> Level V (Therapeutic).