MADERA, Calif. – An innovative surgical technique developed by experts at Valley Children’s is now being shared nationwide after its publication in a medical journal, providing pediatric surgeons with a new approach to improve outcomes for children across the country.
The technique, dubbed the “double opposing stiletto flap technique,” was developed by the Division of Plastic and Hand Surgery at Valley Children’s in response to a large number of patients experiencing the same complex hand condition.
“We have a high volume of patients that we see with pediatric hand problems, and one that we frequently see is a finger contracture, which means that the finger is bent down more than typical,” said Dr. Michael Galvez, director of the Hand and Upper Extremity Program at Valley Children’s.
A common cause of the issue can be treadmill-related burns, caused when a child puts their finger on a running treadmill, Dr. Galvez said. While the initial burn injury may heal with treatment, scar tissue can tighten over time, contracting the finger and eventually preventing the child from straightening it fully.
Without the ability to straighten their finger, patients are unable to lay their hands flat on a table, making everyday activities – such as gripping objects – more difficult.
“Since we have this high volume of patients, you have to get creative,” Dr. Galvez said.
That creativity led to the development of the double opposing stiletto flap technique, which involves using skin from both sides of the finger and repositioning them to reconstruct the scarred area. The first patient the procedure was performed on regained the ability to fully straighten his finger, and since then, the team has successfully performed the technique 12 times.
Because they had enough cases, the team was able to have the case series published in the Journal of Hand Surgery Global Online. The article was authored by Dr. Galvez, Nurse Practitioner Lauren Perry and Hannah Korah from the University of Arizona College of Medicine.
Dr. Galvez emphasized that the success of this work reflects a true team effort – from the pediatric hand surgery navigators who identify and coordinate patients, to the support of the operating room team and the research team, to the nursing staff who provide postoperative care and the hand therapy team, whose critical role helps patients heal and regain function after surgery.
“It’s something that we’ve innovated here, and hopefully we can continue to advocate for this technique to help kids use their own tissue to get their finger straight, flat and functional for use,” he said.
That advocacy and innovation have led to other surgeons using the technique after it was published by the Valley Children’s team, Dr. Galvez says.
“It’s a privilege and a responsibility,” said Dr. Galvez. “If we have this experience, if we can develop new techniques, then the next step is to teach other centers and give them new techniques to help them take better care of kids across the country.”
To view the case series study in full, click here.
