<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922023000400011</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922023000400011</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Técnica de Miura modificada en pacientes con sindactilia congénita completa del primer espacio sin asociación a mano hendida]]></article-title>
<article-title xml:lang="en"><![CDATA[Modified Miura technique in complete congenital syndactyly of the first space not associated with cleft hand]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vidal-Toscanini]]></surname>
<given-names><![CDATA[Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Navia-Torelli]]></surname>
<given-names><![CDATA[Alfonso]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jorquera]]></surname>
<given-names><![CDATA[Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-De Arce-Bown]]></surname>
<given-names><![CDATA[Macarena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barril-Merino]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Dr. Luis Calvo Mackenna  ]]></institution>
<addr-line><![CDATA[Santiago ]]></addr-line>
<country>Chile</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Red de Salud UC Christus  ]]></institution>
<addr-line><![CDATA[Santiago ]]></addr-line>
<country>Chile</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Dr. Luis Calvo Mackenna  ]]></institution>
<addr-line><![CDATA[Santiago ]]></addr-line>
<country>Chile</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Pontificia Universidad Católica de Chile  ]]></institution>
<addr-line><![CDATA[Santiago ]]></addr-line>
<country>Chile</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<volume>49</volume>
<numero>4</numero>
<fpage>381</fpage>
<lpage>386</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922023000400011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922023000400011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922023000400011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y objetivo. La sindactilia es la anomalía congénita más frecuente de la extremidad superior. El compromiso del primer espacio es una patología rara pero genera importante deterioro funcional, por lo que el tratamiento quirúrgico es esencial para restaurar la función de prensión del pulgar. Están descritas múltiples estrategias quirúrgicas para lograr un primer espacio adecuado (igual o mayor a 90°), que incluyen desde colgajos locales y/o zetaplastias en sindactillias incompletas, hasta el uso de colgajos libres de antebrazo o expansores tisulares para sindactilias completas, con resultados funcionales variables y posible compromiso de zonas dadoras. Centramos nuestro trabajo en el empleo de la técnica de Miura modificada, presentado 2 casos clínicos.  Material y método. Describimos el uso de la técnica Miura modificada en 2 pacientes de 14 y 5 meses de edad respectivamente, para la resolución de sindactilia congénita completa del primer espacio sin asociación a mano hendida.  Resultados. El seguimiento fue de 40 meses para el caso 1 y de 26 meses para el caso 2. No hubo complicaciones tempranas ni tardías ni evidencia de retracción de la cicatriz, manteniendo la amplitud del primer espacio de 90° en ambos pacientes, con buen resultado funcional y estético.  Conclusiones. En nuestra experiencia, el uso de la técnica de Miura modificada es una alternativa interesante para el tratamiento de la sindactilia del primer espacio no asociada a mano hendida, con un colgajo vascularmente seguro, de diseño sencillo, con buenos resultados funcionales y mínimas consecuencias estéticas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and objective. Syndactyly is the most frequent congenital anomaly of the upper limb. Syndactyly of the first space is rare, but compromises functionality, so surgical treatment is essential to restore the thumb grip function. Multiple surgical strategies to achieve adequate space (equal to or greater than 90 °) have been described. These techniques include from the use of local flaps and/or zetaplasties in incomplete syndactyly, until the use of remote flaps from the forearm and tissue expanders if it is a completely absent space, with variable functional results and/or involvement of donor areas. This paper focus on the use of modified Miura technique and presents 2 clinical cases.  Methods. The use of modified Miura technique in 2 patients, 14 and 5 months old respectively, is described in the resolution of complete congenital syndactyly of the first space not associated with a cleft hand,  Results. Follow-up was 40 months for case 1 and 26 months for case 2. There were no early or late complications or evidence of scar retraction, maintaining the width of the first 90° space in both patients, with good functional and aesthetic results at long term follow up.  Conclusions. In our experience, the use of the modified Miura technique is an interesting alternative for the treatment of first space syndactyly not associated with cleft hand, with a vascularly safe flap, of simple design, with good functional results and minimal aesthetic consequences.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Sindactilia]]></kwd>
<kwd lng="es"><![CDATA[Mano congénita]]></kwd>
<kwd lng="es"><![CDATA[Deformidad extremidades]]></kwd>
<kwd lng="es"><![CDATA[Técnica Miura]]></kwd>
<kwd lng="en"><![CDATA[Syndactyly]]></kwd>
<kwd lng="en"><![CDATA[Congenital hand]]></kwd>
<kwd lng="en"><![CDATA[Limb deformities]]></kwd>
<kwd lng="en"><![CDATA[Miura technique]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bentz]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Zuker]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<source><![CDATA[Principles and Practice of Pediatric Plastic Surgery]]></source>
<year>2017</year>
<page-range>5484-90</page-range><publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Tylor and Francis]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ghazi]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Upton III]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Congenital Hand Anomalies and Associated Syndromes]]></source>
<year>2014</year>
<page-range>367-80</page-range><publisher-loc><![CDATA[Berlin Heidelberg ]]></publisher-loc>
<publisher-name><![CDATA[Springer-Verlag]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Walchak]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rayan]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Congenital Thumb-Index Web Space Deficiency]]></article-title>
<source><![CDATA[Hand]]></source>
<year>2019</year>
<page-range>1-7</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kalliainen]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Schubert]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Management of Web Space Contractures]]></article-title>
<source><![CDATA[Clin in Plast Surg]]></source>
<year>2005</year>
<volume>32</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>503-11</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miura]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Komada]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simple method of reconstruction of the Cleft hand an adducted thumb]]></article-title>
<source><![CDATA[Plast Reconst Surg]]></source>
<year>1979</year>
<volume>64</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>65-7</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beck]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[NF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Over 20-year follow-up of Miura reconstruction of cleft hand]]></article-title>
<source><![CDATA[Hand (NY)]]></source>
<year>2015</year>
<volume>10</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>319-22</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Richterman]]></surname>
<given-names><![CDATA[IE]]></given-names>
</name>
<name>
<surname><![CDATA[DuPree]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Thoder]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The radiographic analysis of web height]]></article-title>
<source><![CDATA[J Hand Surg Am]]></source>
<year>1998</year>
<volume>23</volume>
<page-range>1071-6</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jensen]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
<name>
<surname><![CDATA[Rayan]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
<name>
<surname><![CDATA[Davidson]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[First web space contracture and hand function]]></article-title>
<source><![CDATA[J Hand Surg Am]]></source>
<year>1993</year>
<volume>18</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>516-20</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Braun]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Trost]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Pederson]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Syndactyly Release]]></article-title>
<source><![CDATA[Semin Plast Surg]]></source>
<year>2016</year>
<volume>30</volume>
<page-range>162-70</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Suliman]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experience with the seven flap-plasty for the release of burns contractures]]></article-title>
<source><![CDATA[Burns]]></source>
<year>2004</year>
<volume>30</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>374-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Friedman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Wood]]></surname>
<given-names><![CDATA[VE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Dorsal Transposition Flap for Congenital Contractures of the First Web Space: A 20-Year Experience]]></article-title>
<source><![CDATA[J Hand Surg Am]]></source>
<year>1997</year>
<volume>22</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>664-70</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ghani]]></surname>
<given-names><![CDATA[HA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modified Dorsal Rotation Advancement Flap for Release of the Thumb Web Space]]></article-title>
<source><![CDATA[J of Hand Surg]]></source>
<year>2006</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>226-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coombs]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mutimer]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tissue expansion for the treatment of complete syndactyly of the first web]]></article-title>
<source><![CDATA[J Hand Surg Am]]></source>
<year>1994</year>
<volume>19</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>968-72</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Upton]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Havlik]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Coombs]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of forearm flaps for the severely contracted first web space in children with congenital malformations]]></article-title>
<source><![CDATA[J Hand Surg Am]]></source>
<year>1996</year>
<volume>21</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>470-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
