Comment on Shevtsov and Danilkin: Application of external fixation for management of hand syndactyly

We read with deep interest the article by Shevtsov and Danilkin [1]. Indeed, those who deal with syndactyly are well aware of the complications of the transferred skin flaps and skin grafts. Distraction of the intervening soft tissues by distractor assembly is a possible answer to these complications.

Since use of an external fixator is a rare practice, the authors should describe the technique in more detail for the less experienced user. The technique described left certain queries unanswered. The corkscrew-like bent wires the authors used are perhaps not a part of standard Ilizarov equipment. The authors do not make mention of any difficulty in removing the embedded corkscrew-like wires from the volar aspect of fingers in small children with relatively soft bones after the distraction period is over. The distraction rate for a finger external fixator assembly and the rationale for a static period (fixation period) of 25 days are not given. Further, inserting the wires at 45° would also be likely to produce rotation deformities of fingers because of coronal forces arising from distraction.