Journal articles: 'Syndactyly'

1

Eaton, Charles James, and Graham Duncan Lister. "Syndactyly." Hand Clinics 6, no. 4 (November 1990): 555–75. http://dx.doi.org/10.1016/s0749-0712(21)01056-8.

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Berger, Aaron J., and Nicole C. Cabbad. "Syndactyly." Techniques in Orthopaedics 34, no. 1 (March 2019): 12–17. http://dx.doi.org/10.1097/bto.0000000000000356.

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Kozin, Scott H. "Syndactyly." Journal of the American Society for Surgery of the Hand 1, no. 1 (February 2001): 1–13. http://dx.doi.org/10.1053/jssh.2001.21778.

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Arteaga-Solis, Emilio, Barbara Gayraud, Sui Y. Lee, Lillian Shum, Lynn Sakai, and Francesco Ramirez. "Regulation of limb patterning by extracellular microfibrils." Journal of Cell Biology 154, no. 2 (July 23, 2001): 275–82. http://dx.doi.org/10.1083/jcb.200105046.

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To elucidate the contribution of the extracellular microfibril–elastic fiber network to vertebrate organogenesis, we generated fibrillin 2 (Fbn2)–null mice by gene targeting and identified a limb-patterning defect in the form of bilateral syndactyly. Digit fusion involves both soft and hard tissues, and is associated with reduced apoptosis at affected sites. Two lines of evidence suggest that syndactily is primarily due to defective mesenchyme differentiation, rather than reduced apoptosis of interdigital tissue. First, fusion occurs before appearance of interdigital cell death; second, interdigital tissues having incomplete separation fail to respond to apoptotic clues from implanted BMP-4 beads. Syndactyly is associated with a disorganized matrix, but with normal BMP gene expression. On the other hand, mice double heterozygous for null Fbn2 and Bmp7 alleles display the combined digit phenotype of both nullizygotes. Together, these results imply functional interaction between Fbn2-rich microfibrils and BMP-7 signaling. As such, they uncover an unexpected relationship between the insoluble matrix and soluble factors during limb patterning. We also demonstrate that the Fbn2- null mutation is allelic to the recessive shaker-with-syndactyly (sy) locus on chromosome 18.

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Perlman, J. M., and J. A. Bos-wick. "CONGENITAL SYNDACTYLY." Journal of Pediatric Orthopaedics 7, no. 2 (March 1987): 246. http://dx.doi.org/10.1097/01241398-198703000-00058.

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Colville, John. "Syndactyly correction." British Journal of Plastic Surgery 42, no. 1 (January 1989): 12–16. http://dx.doi.org/10.1016/s0007-1226(89)90106-9.

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7

McKinnon, A. "Syndactyly correction." Journal of Pediatric Surgery 25, no. 3 (March 1990): 361. http://dx.doi.org/10.1016/0022-3468(90)90099-u.

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Braun, Tara, Jeffrey Trost, and William Pederson. "Syndactyly Release." Seminars in Plastic Surgery 30, no. 04 (November 18, 2016): 162–70. http://dx.doi.org/10.1055/s-0036-1593478.

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Chouairi, Fouad, Michael R. Mercier, J. Scott Persing, Kyle S. Gabrick, James Clune, and Michael Alperovich. "National Patterns in Surgical Management of Syndactyly: A Review of 956 Cases." HAND 15, no. 5 (February 15, 2019): 666–73. http://dx.doi.org/10.1177/1558944719828003.

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Purpose: Being one of the most common congenital hand malformations, syndactyly is repaired by orthopedic, plastic, and fellowship-trained general surgeons. Limited multi-institutional outcomes analyses regarding incidence, timing, and type of repair exist. Methods: All syndactyly cases performed over a 5-year period from 2012-2016 were isolated from the National Surgical Quality Improvement Program Pediatric database. Patient demographics, surgical factors, perioperative outcomes, and risk factors were analyzed using χ2, Fisher exact, and t-test analysis. Results: A total of 956 patients who underwent syndactyly repair were identified. Most cases were simple syndactyly with nearly even case distribution among plastic and orthopedic surgeons. Most patients were men and Caucasian. Mean age at the time of surgery was 2.6 years. Most cases were performed as outpatient surgery. Patients of plastic surgeons had significantly more airway abnormalities and shorter operative times. Patients with complex syndactyly had significantly more ventilator dependence, tracheostomy, and comorbidities when compared with those with simple syndactyly. Cases with complex syndactyly also had longer operative times and a higher rate of superficial surgical site infections. Conclusions: Syndactyly repair is a safe procedure with few major or minor reconstructive complications regardless of the surgical specialty or syndactyly type. Patients with complex syndactyly have significantly more preoperative comorbidities with comparable outcomes. orthopedic surgeons have significantly longer operative times than plastic surgeons, likely due to caring for increased number of patients with complex syndactyly.

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Fazlani, Rizwana, Kashan Qayoom Shaikh, Zuhera Khan, Yasir Arfat Memon, Sadia Rasheed, and Najamuddin Fazlani. "Functional Outcome of Syndactyly Repair in Children." Pakistan Journal of Medical and Health Sciences 15, no. 10 (October 30, 2021): 3375–77. http://dx.doi.org/10.53350/pjmhs2115103375.

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Background: As the most prevalent form of congenital hand malformation, syndactyly carries significant aesthetic and practical implications. For the vast majority of situations, surgery is the best option. Congenital syndactyly can be repaired with skin grafts and local flaps, however the results are often less functional and cosmetic than anticipated and often leave scars and residual syndactyly. So we set out to find out how children's syndactyly healing went in this study.1 Objective: To analyze the functional outcome of syndactyly repair in children presenting in a tertiary care hospital. Methodology: This Descriptive case series was conducted at Department of Plastic and Reconstructive Surgery, LUMHS Jamshoro / Hyderabad for 6 months. Sample size of 180 cases was recruited through Non-probability consecutive sampling. Then all patients underwent surgery under general anesthesia. In all cases, procedure was performed depends upon the type / extent of syndactyly. Then patients were discharged after recovery and were followed up on 1st, 2nd and 3rd months post operatively for assessment of functional outcome of syndactyly repair i.e. no supination and no pronation was noted. All this information was noted on proforma. Data was entered and analyzed using SPSS 22.0. Results: The mean age of children was 6.30+3.55. There were 66 (37%) females and 114 (63%) male in the sample. There were 128 (71%) cases of simple syndactyly and 52 (29%) cases of complex syndactyly. There were 127 (71%) cases who had no-supination, 162 (90%) cases who had no-pronation. There was significant difference observed between both type of syndactyly (P<0.05) for supination while insignificant for pronation. Conclusion: Thus we have found that syndactyly repair is effective technique through which we can attain success in maximum number of patients which can help in achieving normal angulation of fingers after surgery. Key words: Syndactyly, Pronation, Supination, Angulation, Children

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11

Nareswari, Tara, and Farah Hendara Ningrum. "Seorang Anak Perempuan 1 Bulan Dengan Apert Syndrom (Acrocephalosyndactyly Syndrome Type 1)." Medica Hospitalia : Journal of Clinical Medicine 9, no. 1 (March 28, 2022): 99–110. http://dx.doi.org/10.36408/mhjcm.v9i1.707.

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Latar Belakang Sindrom apert merupakan salah satu jenis acrocephalosyndactyly yang paling dikenal dan disebabkan oleh mutasi gen fibroblast growth factor receptors2 (FGFR2) Acrocephalosyndactyly didefinisikan sebagai sindrom kongenital ditandai dengan penutupan yang terlalu dini dari sutura sutura tengkorak (craniosynostosis) Hal ini menghasilkan kepala dan wajah yang berbentuk tidak normal, serta fusi jari tangan dan kaki (sindactyly) 1. Tujuan studi kasus ini adalah untuk mengetahui penegakhan diagnosis sindrom apert Laporan kasus Pasien datang ke poli anak RS Kariadi Semarang tanggal 15 Oktober 2018 yang merupakan rujukan dari RS Keluarga Sehat Pati, dengan assesment suspek sindrom tertentu DD/ Craniosinostosis syndrom, Baller gerold syndrom. Orangtua pasien mengeluhkan bahwa saat bernafas anak berbunyi grok grok. Kesan dari pemeriksaan radiologi skeletal survey adalah Craniosynostosis yang membentuk gambaran Harlequin Eye, Syndactyly manus kiri, Polyndactyly pedis kiri, yang mana dari keseluruhan tanda klinis tersebut mendukung gambaran Apert Syndrome. Sedangkan kesan dari pemeriksaan MSCT kepala tanpa kontras adalah Sutura coronaria kanan kiri tampak sudah menutup, microcephali, brachicephalic, tak tampak gambaran hidrocephalus, tak tampak kalsifikasi patologis yang mencurigakan suatu infeksi kongenital, tak tampak tanda tanda peningkatan tekanan intracranial Pembahasan Apert syndrome (acrocephalosyndactyly) adalah kelainan perkembangan yang jarang terjadi, ditandai oleh craniosynostosis, hipoplasia midface, syndactili simetris tangan dan kaki. Karakteristik prodromal untuk penampilan wajah-cranio yang khas adalah craniosynostosis awal jahitan koronal, dasar kranial dan agenesis dari jahitan sagital. Apert Syndrome adalah sindrom craniosynostosis yang paling dikenal luas Apert syndrome merupakan acrocephalosyndactyly tipe I adalah malformasi kongenital yang langka dengan dikarakteristikan oleh kraniosinostosis, hipoplasia mid-face, syndactyly pada tangan dan kaki. Pada pasien ini tampak synostosis sutura coronaria kanan kiri yang membentuk gambaran harlequin eye. Syndactyly tangan dan kaki, dengan syndactyly pada tangan yaitu tipe 2 atau biasa disebut mitten hand yaitu tampak fusi jari ke 2- 4 tanpa keikutsertaan ibu jari. Dengan penampilan klinis pada mid face pasien menunjukan wajah dismorfik, flat facies, mata proptosis, hidung low nasal bridge, dan mulut palatum letak tinggi Kesimpulan Apert Syndrom merupakan salah satu tipe Acrocephalosyndactyly yaitu kelainan kongenital akibat mutasi heterozigot pada gen FGFR2 dengan sifat dominant autosomal, yang ditandai dengan craniosinostosis, hipoplasia midface, dan syndactyly pada tangan dan kaki. Pemeriksaan radiologi memiliki peranan penting dalam mendiagnosa kelainan ini

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Nangineedi, Nagaprasad, Gangavaram Praveen Harish, and Mohammed Rafi. "Management of syndactyly: a clinical study." International Surgery Journal 6, no. 8 (July 25, 2019): 2806. http://dx.doi.org/10.18203/2349-2902.isj20193320.

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Background: Syndactyly is a congenital anomaly, basic principles of surgical release of syndactyly have been well established, each patient requires a thorough assessment of the soft-tissue and bony components in the syndactylized region. Reconstruction must be planned carefully when more than two digits are involved or when the syndactyly is a component of a systemic congenital syndrome. The aim of the treatment strategies for syndactyly is to separate the fused digits, create a functional hand, and produce an aesthetically acceptable web.Methods: The prospective clinical study is conducted in the Department of Plastic & Reconstructive surgery, between October 2016 to October 2018. Twenty six patients with congenital syndactyly and post burn syndactyly of fingers were included in this study.Results: There were no intra operative complications and no cases had any neurovascular compromise. Integrity of Dorsal and volar flaps, quality of scars, aesthetical aspects of fingers are reasonably good in almost all the cases that are operated in this study. Overall 97% of patients treated achieved good function and superior results following single surgery.Conclusions: Primary syndactyly is more common than secondary syndactyly. In this study the primary goal is separation of fused digits/toes and covering the web space with dorsal flap, and covering the separated digits/ toes with a graft and create a functional hand and produce an aesthetically web with fewest complications and fewest surgical corrections.

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Harbuzniak, Iryna, and Anastasiia Hrуtsenko. "Features of surgical correction of various forms of hand syndactyly in children. Retrospective study of own treatment experience." ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, no. 2 (October 12, 2021): 5–9. http://dx.doi.org/10.15674/0030-5987202125-9.

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Syndactyly is a congenital malformation which is characterized by impaired differentiation of upper extremity tissues. Surgical correction of syndactyly is aimed to achieve satisfactory cosmetic and functional result. Most often, elimination of the total syndactyly form of the fingers implies is achieved by techniques according to Flatt (1962), Cronin (1943), Gilbert (1986), Wood (1998), bone form requires usage of Buck-Gramko technique. Objective. To conduct a retrospective study of surgical treatment results in patients with various forms of hand syndactyly. Methods. The study included 84 patients (109 hands) with hand syndactyly who were operated during the period from 2012 to 2020 in the pediatric orthopedics clinic of the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. The mean age of patients was 6.5 years (1 to 16), 39 (46.4 %) boys and 45 (53.6 %) girls. Most often syndactyly of III–IV fingers (105 (96.3 %) hands) was managed by the Wood method, namely in 63 (60.0 %) hands and 8 (7.6 %) cases with severe bone forms were corrected by Buck-Gramko method. Rotational skin pieces Ghani and Buck-Gramko were used for surgical correction of I–II fingers syndactyly. Treatment results were evaluated by the Vancouver Scar Scale (VSS). Results. According to VSS, the treatment result was classified as satisfactory in 73 (67.0 %) hands. Complications were noted in 11 (10.1 %) cases: 2 patients (18.2 % of 11) with congenital amniotic membranes were found to have lysis of a free skin piece; 1 (9.1 %) after removal of the bony syndactyly form had deviation of the nail phalanx; 3 (27.3 %) with Poland-syndrome were shown to have scarring of the interdigital space; 5 (45.4 %) with a complex bony form of syndactyly further on developed pulling scars, which caused deformity of the fingers and resulted in a correction in the form of multistage Z-plastics. Conclusions. All the patients showed improvement in the function and cosmetic results of the hand at the end of treatment. The best results were obtained in the case of simple and total forms of syndactyly treated with Wood technique.

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Gallego, M., and L. Avedillo. "Case Report of Bilateral 3-4 Metatarsal Syndactyly in a Pet Rabbit." Case Reports in Veterinary Medicine 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/6957101.

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We report the first case of spontaneous syndactyly reported in a pet rabbit. Syndactyly only caused an atypical gait in the rabbit. The radiological study revealed bilateral 3rd and 4th metatarsal bones fused in its entire length preserving normal joint surfaces resembling syndactyly type Ia. The cause of this congenital malformation was unknown.

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Hutchinson, Douglas T., and Seth W. Frenzen. "Digital Syndactyly Release." Techniques in Hand & Upper Extremity Surgery 14, no. 1 (March 2010): 33–37. http://dx.doi.org/10.1097/bth.0b013e3181cf7d70.

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DAO, KHIEM D., VIRCHEL E. WOOD, and ANNETTE BILLINGS. "Treatment of Syndactyly." Techniques in Hand & Upper Extremity Surgery 2, no. 3 (September 1998): 166–77. http://dx.doi.org/10.1097/00130911-199809000-00004.

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Marsh, D. J., and D. Floyd. "Toe syndactyly revisited." Journal of Plastic, Reconstructive & Aesthetic Surgery 64, no. 4 (April 2011): 535–40. http://dx.doi.org/10.1016/j.bjps.2010.07.016.

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Malik, Sajid. "Mesoaxial synostotic syndactyly with phalangeal reduction (MSSD): syndactyly type IX." Skeletal Radiology 47, no. 2 (December 11, 2017): 149. http://dx.doi.org/10.1007/s00256-017-2842-z.

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AL-QATTAN, M. M. "Variable Expression of Isolated Familial Long-Ring-Little Syndactyly." Journal of Hand Surgery 25, no. 4 (August 2000): 400–402. http://dx.doi.org/10.1054/jhsb.2000.0380.

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Rauniyar, RK, S. Baboo, U. Sharma, and M. Garg. "A Variant of Poland’s syndrome - Case Report and Review of Literature." Nepalese Journal of Radiology 1, no. 1 (June 16, 2012): 65–69. http://dx.doi.org/10.3126/njr.v1i1.6328.

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Poland’s syndrome is the association of congenital thoracic abnormalities with ipsilateral syndactyly along with various other associated anomalies. A variant of Poland’s syndrome without syndactyly along with review of literature is presented here. Various associated anomalies of the syndrome is summarized. Syndactyly believed to be constant features in Poland’s Syndrome in earlier reports, may not be present.DOI: http://dx.doi.org/10.3126/njr.v1i1.6328 Nepalese Journal of Radiology Vol.1(1): 65-69

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TONKIN, M. A., K. R. WILLIS, and R. D. LAWSON. "KELOID FORMATION RESULTING IN ACQUIRED SYNDACTYLY OF AN INITIALLY NORMAL WEB SPACE FOLLOWING SYNDACTYLY RELEASE OF AN ADJACENT WEB SPACE." Journal of Hand Surgery (European Volume) 33, no. 1 (February 2008): 29–31. http://dx.doi.org/10.1177/1753193408087124.

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AL-QATTAN, M. M. "Expression of Familial Middle–Ring–Little Finger Syndactyly as Either Simple Syndactyly or Synpolydactyly." Journal of Hand Surgery 31, no. 1 (February 2006): 118–20. http://dx.doi.org/10.1016/j.jhsb.2005.07.006.

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Tanuwijaya, Lucretya Yeniwati, Agus Roy Rusly Hariantana Hamid, and I. Gusti Putu Hendra Sanjaya. "The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report." International Journal of Health Sciences and Research 12, no. 1 (January 5, 2022): 87–91. http://dx.doi.org/10.52403/ijhsr.20220112.

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Background: Acquired syndactyly is a very rare disorder on the interdigital area. Syndactyly with only soft tissue involvement can be a sequela of trauma, such as burn, inflammation or infection in the interdigital area, resulting in bony fusion following crush injury. Case Report: An 8-year-old boy came to our department with fusion from the base to the tip of the first to fourth right toes since the accidental step on burnt plastic 5 years ago. He complained of a poor appearance and discomfort when walking. Then we performed zigzag incision for first to second toes and third to fourth toes. Skin graft closure was performed to cover the defect on third to fourth toes. The second reconstruction surgery will be scheduled 6 months later. Discussion: The surgical techniques for foot syndactyly were derived from those for hand syndactyly, which are to separate the digital fusion by creating local skin flap. Additionally, skin graft might be necessary when recent surgeons avoid the use of skin graft for open treatment, primary closure by defatting, or intricate local flaps. These can shorten the operation time and minimize donor site morbidity. However, surgeons should consider the free tension closure of the wound by combining the skin graft after the flap. Conclusion: Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. The skin graft addition in combination of skin flap shows promising outcome. Key words: acquired syndactyly, syndactyly reconstruction, zigzag flap, skin graft.

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Kong, Bong Young, Goo Hyun Baek, and Hyun Sik Gong. "TREATMENT OF KELOID FORMATION FOLLOWING SYNDACTYLY DIVISION: SURGICAL TECHNIQUE." Hand Surgery 17, no. 03 (January 2012): 433–37. http://dx.doi.org/10.1142/s0218810412970088.

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A strong association has been reported between keloid formation after syndactyly reconstruction and primary digital enlargement, and methotrexate (MTX) treatment has been shown to produce promising results in a few reported cases. However, detailed surgical technique for revision of keloid formation after syndactyly division has not been well described, and there is still no standard treatment protocol regarding use of MTX in such cases. In this paper, we describe the technical details of keloid excision and full thickness skin grafting followed by MTX medication for the treatment of massive keloid formation after syndactyly division. We also describe a case of unsuccessful use of MTX, and our experience of its prophylactic use for a patient with syndactyly with primary digital enlargement.

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Mansoor, Palwasha, Rao Saood Ahmed, and Shahid Hameed. "Comparison of Outcomes Following Syndactyly Release with Grafts and Without Grafts." Pakistan Armed Forces Medical Journal 72, no. 3 (June 21, 2022): 796–800. http://dx.doi.org/10.51253/pafmj.v72i3.4289.

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Objective: To compare the results of syndactyly release with or without graft in patients with simple syndactyly of hand. Study Design: Prospective comparative study. Place and Duration of Study: Department of Plastic Surgery, Combined Military Hospital Rawalpindi Pakistan, from Jul 2017 to Jun 2019 Methodology: Forty-five patients with simple syndactyly were included in this study. Group-1 had 20 patients whose syndactyly was released without using a skin graft. Group-2 had 25 patients whose soft tissue was covered with a fullthickness skin graft between the flaps post syndactyly release. Both groups were compared based on operative time, wound healing time, and when physiotherapy was started post operatively. Results: The results of our study showed that the mean operative time for the first group was 47.1 ± 4.5 minutes (range 35-60 minutes) and for the second group 90.5 ± 10.0 minutes (range 72-108 minutes) with a p-value <0.001. The wound healing time for the first group was 15.2 ± 1.3 days (12-18 days’ range) and for the second group was 22.5 ± 5.1 days (range 14-30 days) with a p-value <0.001. Post-operative physiotherapy was started earlier in the first group with an average of 20.6 ± 1.3 days (18-22 days’ range) as compared to the second group whose average time of the start of physiotherapy was 27.7 ± 4.4 days (range 20- 35 days) with p-value <0.001. Conclusion: Syndactyly release without a skin graft has a lesser operative time, early wound healing and an earlier start of physiotherapy than syndactyly release with......

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Kusuma, Diana Murtiati, Beta Subakti Nata'atmadja, Iswinarno Doso Saputro, and Sitti Rizaliyana. "Deviation and Atrophy of Middle Phalanx of Hand Following Partial Separation in Syndactyly Patient: Their Fault or Ours?" Jurnal Rekonstruksi dan Estetik 3, no. 1 (January 8, 2021): 7. http://dx.doi.org/10.20473/jre.v3i1.24366.

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Backgrounds: Syndactyly is failure of differentiation in which the fingers fail to separate into individual appendages. It is the most common congenital hand anomaly, with an incidence of 1 in 2,000 to 2,500 live births. Surgical separation of fingers as early as 6 month-old is indicated when syndactyly involves digits of unequal length (i.e., ring and little fingers). Early separation is also required in complex syndactyly and cases of acrosyndactyly. The timing of surgery of all other cases of syndactyly remains somewhat controversial; most suggest surgical correction before age of 18 months, whereas others prefer to wait until after this age.Case Presentation and Operation Technique: A 13-year old boy, presented with fusion of all fingers of the right hand at birth. Prior to his current visit, he underwent partial separation of the right fingers at the age of 6 y.o. at a local hospital. Following partial separation, the fingers did not grow normally. Current X-ray showed atrophy and deviation of middle phalanx. We performed separation of syndactyly between index and middle finger, and between fourth and small finger in our hospital. Interdigital webbings are released using local flap and the remaining raw surface is covered using full-thickness skin grafts. On follow up, the patient showed good functional and aesthetic outcome. He is able to write with his right hand with better coordination.Discussion: Complex syndactyly reconstruction is a challenging surgical problem. Common post surgical findings include rotational deformity, angular deformity, and nail deformity. We describe how we have altered our approach in these findings.Conclusion: Congenital syndactyly should be corrected early in life. Careful dissection, the use of a dorsal rectangular flap in combination with 2 volar triangular flaps, and use of full thickness skin grafts ensure a satisfactory outcome and minimize the number of operations per web

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Canizares, Maria F., Lanna Feldman, Patricia E. Miller, Peter M. Waters, and Donald S. Bae. "Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System." HAND 12, no. 4 (September 12, 2016): 327–34. http://dx.doi.org/10.1177/1558944716668816.

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Background: Syndactyly is one of the most common congenital differences of the upper extremity and offers an exceptional opportunity to evaluate value-based care in pediatric orthopedic surgery. We designed a study to characterize complications and cost associated to syndactyly surgery among US pediatric hospitals. Methods: A total of 2047 patients were identified for syndactyly surgery at 38 pediatric hospitals from 2009 to 2012 using the Pediatric Health Information System (PHIS) database. We examined costs as well as complication rates across hospitals stratified by patient and hospital variables. Results: The postoperative complication rate was 1.9% (95% confidence interval [CI]: 1.3%-2.5%). Postoperative infection rate was 1.6% and surgical complication rate was 0.3%. Median adjusted standardized cost was $4112.5 (interquartile range: $2979-$6049). Patients with more than 1 diagnosis had 19 times higher risk of complications and were associated with 13% more hospital cost than those with syndactyly as single diagnosis ( P < .001). Finally, there was a wide variation in cost across hospitals; 8 (21%) yielded confidence limits above the benchmarked value. Conclusions: In the United States, it is important to recognize variations in practice of syndactyly surgery in hopes of developing quality improvement strategies in pediatric orthopedic surgery.

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Cantrell, Stephen B., Mark H. Moore, James A. Trott, Robert J. Morris, and David J. David. "Phenotypic Variation in Acrocephalosyndactyly Syndromes: Unusual Findings in Patient with Features of Apert and Saethre-Chotzen Syndromes." Cleft Palate-Craniofacial Journal 31, no. 6 (November 1994): 487–93. http://dx.doi.org/10.1597/1545-1569_1994_031_0487_pviasu_2.3.co_2.

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The acrocephalosyndactyly syndromes have presented diagnostic challenges because of overlap in their clinical manifestations. We present a patient with features most suggestive of Apert syndrome, but with a pattern of syndactyly not previously described. In contrast to the complex syndactyly reported as a universal feature of this syndrome, this patient shows close to total simple syndactyly of the index through ring fingers of each hand. Differential diagnoses are discussed. Because the features are reminiscent of Apert syndrome, we suggest that a new classification of hand morphology should be added to include the pattern described here.

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Kanauchi, Yumiko, Masatoshi Takahara, Toshihiko Ogino, Hideo Kashiwa, and Daisuke Ishigaki. "INTERCALARY NON-VASCULARISED TOE PHALANX TRANSPLANTATION FOR SHORT FINGER-TYPE SYMBRACHYDACTYLY." Hand Surgery 08, no. 02 (December 2003): 243–47. http://dx.doi.org/10.1142/s0218810403001790.

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A two-year-old boy with short finger-type symbrachydactyly involving the index, middle, and ring fingers was treated with intercalary nonvascularised toe phalanx transplantation into the middle finger to obtain stability of the middle finger before syndactyly release. He underwent syndactyly release one year after the transplantation. Two years after the transplantation, the clinical result was satisfactory, although X-ray showed fibrous union between the transplanted phalanx and the host phalanx. Intercalary nonvascularised toe phalanx transplantation is one of the way of stabilising a finger after syndactyly release.

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Duran, Alpay, and Hasan Buyukdogan. "A Case of Nonsyndromic Unilateral Cleft Hand with Central Polydactyly, Syndactyly, and Thumb Hypoplasia: Support for a Common Etiology." Journal of Hand and Microsurgery 11, no. 03 (September 27, 2018): 154–56. http://dx.doi.org/10.1055/s-0038-1669364.

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AbstractExperimental studies showed that central polydactyly, syndactyly, and cleft hand might appear when the same teratogenic factor acts on embryos at the same developmental stage. These observations and some clinical cases support the concept that a common etiologic mechanism is involved in the development of these malformations. We report a clinical case that demonstrates the association previously observed in experimental studies. Here, a patient with unilateral nonsyndromic cleft hand, central polydactyly, first web syndactyly, osseous syndactyly between the ring and long fingers, and minor thumb hypoplasia was presented.

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Hassan, Iffat, and Abid Keen. "Ectodermal dysplasia with syndactyly." Indian Journal of Dermatology, Venereology, and Leprology 78, no. 3 (2012): 387. http://dx.doi.org/10.4103/0378-6323.95471.

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Gudushauri, O. H., and L. A. Tvaliashvili. "LOCAL EPIDERMOPLASTY FOR SYNDACTYLY." Journal of Pediatric Orthopaedics 11, no. 6 (November 1991): 816. http://dx.doi.org/10.1097/01241398-199111000-00085.

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Goodman, F. R. "Synpolydactyly (Syndactyly Type II)." Clinical Genetics 49, no. 6 (June 28, 2008): 333. http://dx.doi.org/10.1111/j.1399-0004.1996.tb03804.x.

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Le Hanneur, M., A. Cambon-Binder, M. Bachy, and F. Fitoussi. "Treatment of congenital syndactyly." Hand Surgery and Rehabilitation 39, no. 3 (May 2020): 143–53. http://dx.doi.org/10.1016/j.hansur.2019.12.003.

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Gudushauri, O. H., and L. A. Tvaliashvili. "Local epidermoplasty for syndactyly." International Orthopaedics 15, no. 1 (April 1991): 39–43. http://dx.doi.org/10.1007/bf00210532.

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AL-QATTAN, M. M., and M. A. AL-HUSAIN. "Classification of Hand Anomalies in Apert’s Syndrome." Journal of Hand Surgery 21, no. 2 (April 1996): 266–68. http://dx.doi.org/10.1016/s0266-7681(96)80113-6.

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The literature states that all patients with Apert’s syndrome should have complex (osseous) syndactyly of the index, middle and ring fingers. We describe a case of Apert’s syndrome with simple syndactyly and recommend extending the classification of hand anomalies in Apert’s syndrome.

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Al-Qattan, Mohammad M. "A Review of the Genetics and Pathogenesis of Syndactyly in Humans and Experimental Animals: A 3-Step Pathway of Pathogenesis." BioMed Research International 2019 (September 15, 2019): 1–10. http://dx.doi.org/10.1155/2019/9652649.

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Embryology of normal web space creation and the genetics of syndactyly in humans and experimental animals are well described in the literature. In this review, the author offers a 3-step pathway of pathogenesis for syndactyly. The first step is initiated either by the overactivation of the WNT canonical pathway or the suppression of the Bone Morphogenetic Protein (BMP) canonical pathway. This leads to an overexpression of Fibroblast Growth Factor 8 (FGF8). The final step is the suppression of retinoic acid in the interdigital mesenchyme leading to suppression of both apoptosis and extracellular matrix (ECM) degradation, resulting in syndactyly.

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Tolerton, S. K., and M. A. Tonkin. "Keloid formation after syndactyly release in patients with associated macrodactyly: management with methotrexate therapy." Journal of Hand Surgery (European Volume) 36, no. 6 (March 29, 2011): 490–97. http://dx.doi.org/10.1177/1753193411402146.

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We present a series of cases of keloid formation after release of syndactyly in the hands and feet of children with associated digital overgrowth. The use of methotrexate to suppress keloid formation after release of syndactyly and for control of recurrence after surgery for keloid is effective.

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ASHMEAD, D., and P. J. SMITH. "Tissue Expansion for Apert’s Syndactyly." Journal of Hand Surgery 20, no. 3 (June 1995): 327–30. http://dx.doi.org/10.1016/s0266-7681(05)80087-7.

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Tissue expansion is useful in post-traumatic reconstruction in the upper extremity. Its use has also been proposed in congenital syndactyly. Expanded local skin flaps would in theory provide locally appropriate cover, obviating the need for skin grafts. We report a retrospective assessment of tissue expansion in the management of Apert’s syndactyly. Despite theoretical benefits, tissue expansion significantly increased the required number of operations. The technique was associated with an unacceptable rate of complications, and generated inadequate skin flaps, and web spaces requiring a higher rate of revision than traditional techniques. Despite expectations, tissue expansion for Apert’s syndactyly proved disappointing and is not advocated.

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Shetty, Sanath Kumar, Anoop Hegde, Lawrence John Mathias, and H. Ravindranath Rai. "Congenital Syndactyly of the Fingers : A Report of Two Cases." Journal of Health and Allied Sciences NU 06, no. 01 (March 2016): 082–84. http://dx.doi.org/10.1055/s-0040-1708624.

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AbstractSyndactyly is defined as the failure of separation of the digits during early gestation. It is one of the most common congenital anomalies. The incidence of syndactyly is uncertain, but estimates range from 1 in 2,500 live births. During development, the fingers are webbed. This remains so, until apoptosis and skin recession allow for formation of the digital interspaces. Full inter-digital spaces are usually present by the end of the 6th week of gestation.Here we present two patients and three hands who presented to us with syndactyly of the fingers. The first patient who was a 13 year old girl, had complete complex syndactyly between the ring and middle fingers of both hands. She underwent complete release with full thickness skin grafting in the first sitting. Six weeks later, she was reviewed and was noted to have developed scar contracture of the middle finger for which she underwent contracture release and z-plasty as a secondary procedure. In the final review at four months after the second surgery, the child was noted to have only terminal restriction of movements of the involved fingers of both hands with 'fair results' (as per the criteria of Cortez et al).The second patient was a two years old boy, who presented to us with incomplete simple syndactyly of the ring and index finger of the left hand. He was managed with percutaneous release of the syndactyly. He was reviewed after 4 months and there was full range of movement of the involved digits. He was also noted to have 'fair results' (as per the criteria of Cortez et al).As we had two different cases with a heterogenous presentation of two different types of syndactyly and who underwent different modalities of management, we are presenting it as an interesting case report in our article.

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GOLASH, A., and J. S. WATSON. "Nail Fold Creation in Complete Syndactyly using Buck-Gramcko Pulp Flaps." Journal of Hand Surgery 25, no. 1 (February 2000): 11–14. http://dx.doi.org/10.1054/jhsb.1999.0302.

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We have used the double pulp flap technique described by Buck-Gramcko for nail fold creation in 75 fingertips after separation of 38 complete syndactyly webs in 27 patients. The operative technique is described and the results are discussed. Nail patterns in these complex syndactyly webs are analysed and a classification is proposed.

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Zhao, Xiuli, Miao Sun, Jin Zhao, J. Alfonso Leyva, Hongwen Zhu, Wei Yang, Xuan Zeng, et al. "Mutations in HOXD13 Underlie Syndactyly Type V and a Novel Brachydactyly-Syndactyly Syndrome." American Journal of Human Genetics 80, no. 2 (February 2007): 361–71. http://dx.doi.org/10.1086/511387.

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NEAGU, Tiberiu Paul, Mirela TIGLIS, and Ioan LASCAR. "Bilateral toe syndactyly – short review based on a case report." Romanian Journal of Medical Practice 16, no. 4 (December 31, 2021): 516–19. http://dx.doi.org/10.37897/rjmp.2021.4.21.

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Non-syndromic toe syndactyly is a regular cause of foot malformation in children, bilateral form being less common. Syndactyly release procedures had few contraindications, as uncomplicated malformation or important patient comorbidities. Reported data show that corrective surgery using skin grafts is associated with an increased risk of infection, contractures, and web creep. Reconstruction surgical techniques, using flaps reduce morbidity, revision surgery, complication, may be associated with skin grafts and have superior aesthetic and functional results. We present a case of simple bilateral incomplete asymmetric toe syndactyly, released using a modified personalized local flaps reconstruction technique. The normal function and aesthetic of the feet was obtained, with no complications at one-year follow-up.

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A., Barman, Dutta BC, and Sarkar JK. "Apert syndrome: a case report." National Journal of Clinical Anatomy 04, no. 03 (July 2015): 145–48. http://dx.doi.org/10.1055/s-0039-3401561.

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AbstractApert syndrome was described as a triad of craniosynostosis, syndactyly and maxillary hypoplasia. The incidence of Apert syndrome is approximately one in 50,000 births. A three year old boy was brought with a history of facial, hand and feet deformities to the Pediatrics out patient department. On examination, he had symmetric syndactyly of the hands and feet. He also had craniosynostosis with deformed skull. This patient also exhibited midface hypoplasia, exophthahnia, ocular hypertelorism and high arch palate. Crowding of the teeth, malocclusion with anterior open bite is also found. The X-ray of the hand and feet showed skeletal fusion of phalanges (complex syndactyly). The case represents a rare condition where there is a mutation in the FGFR2 gene causing Apert syndrome.

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Kravljanac, Djordje, Radoje Simic, and Ivan Milovic. "Intraoperative tissue expansion as an alternative approach for hand syndactyly management to avoid skin grafts in children." Vojnosanitetski pregled 75, no. 3 (2018): 290–96. http://dx.doi.org/10.2298/vsp160624347k.

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Background/Aim. A great number of syndactyly release techniques have been described over last two centuries. The aim of our study is outcome assessment of congenital syndactyly surgery using temporary tissue expansion of the dorsal hand and local flaps, without skin grafts. Methods. This study included children with congenital hand syndactyly treated in period from 2009?2015 by operative technique with temporary tissue expansion of the dorsal hand skin and local flaps, without skin grafting. In all cases surgery was performed under general anesthesia. According to Weber?s descriptive method, the functional outcome at the end of the follow-up period was categorized as good, fair or bad. All patients were evaluated for associated anomalies. Results. A total of 26 children (20 males, 6 females), aged from 6 months to 6 years (average age of 23 months), were operated by previously described technique. There were 20 patients with complete syndactyly and 6 with incomplete, mostly involving the third web. Associated anomalies were diagnosed in 9 patients. The follow-up period ranged from 1 to 5 years with average duration of 2.6 years. The functional results were good in 20 patients, fair in 5 and bad in 1 patient. Conclusion. Surgical procedure with temporary tissue expansion of the dorsal hand skin and local flaps, without skin grafting is effective method of congenital syndactyly treatment in children with good functional and aesthetic results. The advantages of this technique are the reduction of surgery duration and avoiding certain complications, such as web hair growth, hyperpigmentation and hypertrophic scars.

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Ad-El, D. D., A. Neuman, and A. Eldad. "SYNDACTYLY REPAIR IN KINDLER SYNDROME." Plastic and Reconstructive Surgery 111, no. 1 (January 2003): 504–5. http://dx.doi.org/10.1097/00006534-200301000-00108.

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Merlob, P., and M. Grunebaum. "Type II syndactyly or synpolydactyly." Journal of Medical Genetics 23, no. 3 (June 1, 1986): 237–41. http://dx.doi.org/10.1136/jmg.23.3.237.

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Smet, L. De, and G. Fabry. "Keloid Formation in Syndactyly Release." Journal of Pediatric Orthopaedics B 6, no. 1 (January 1997): 68–69. http://dx.doi.org/10.1097/01202412-199701000-00014.

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Lorenz, Danielle. "Deformography: An Autoethnography of Syndactyly." Canadian Journal of Disability Studies 9, no. 1 (February 27, 2020): 31–52. http://dx.doi.org/10.15353/cjds.v9i1.595.

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The author of this paper uses autoethnography to explore some of her experiences being born with the congenital malformation syndactyly, calling the process her deformography. She engages in this process for two reasons: a) to move syndactyly out of the medical literature, and b) as a step in a self-empowering process towards acceptance. In so doing, the paper explores social ideologies of difference that have affected her in her lifetime, with particular focus on Ancient Sparta and Nazi Germany. The paper concludes with the author’s realization that although she understands how difference “works” on a cognitive level, she has more to do on her healing journey.

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Jose, R. M., N. Timoney, R. Vidyadharan, and R. Lester. "Syndactyly correction: an aesthetic reconstruction." Journal of Hand Surgery (European Volume) 35, no. 6 (March 17, 2010): 446–50. http://dx.doi.org/10.1177/1753193410362638.

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Various flaps have been used with and without skin grafts to separate digits with syndactyly. Dorsal flap techniques with and without grafts result in dorsal and thus more visible scars. Some of the recent techniques which use no grafts are only applicable for some simple syndactylies. The technique described in this paper uses a combination of techniques which have been described previously. A shaped palmar flap is used to create the web space; narrow V-flaps and full-thickness skin grafts are used to resurface the lateral defects on the fingers and reciprocal pulp flaps are used to create aesthetically pleasing nail folds. This technique allows the full thickness grafts to be hidden on the radial and ulnar sides of the fingers and palm. It increases the span of the hand in conditions where there is shortage of palmar skin. A retrospective review has been undertaken of 102 patients in whom 221 webs were reconstructed through 176 surgical procedures. There were 54 cases of simple syndactylies (53%) and the rest were complex. Complications were encountered in 11 operations (6%) and web creep was noted in 12 web spaces (5%). Re-operation for web creep has been carried out in seven web spaces (3%).

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Journal articles on the topic 'Syndactyly'

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