Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

Canizares, Maria F.; Feldman, Lanna; Miller, Patricia E.; Waters, Peter M.; Bae, Donald S.

doi:10.1177/1558944716668816

Cited by 19 publications

(12 citation statements)

References 58 publications

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“…In addition, we do not have access to any clinical or patient-reported outcome measures to determine outcomes after surgery. However, several previous studies have investigated re-operation rates and complications associated with surgical management[22-24]. Lastly, these results are specific to patients residing in New York State and it is unclear whether these results are generalizable to other populations.…”

Section: Discussionmentioning

confidence: 97%

Epidemiology of syndactyly in New York State

Swarup¹,

Zhang²,

Do³

et al. 2019

WJO

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BACKGROUNDThere is paucity of literature focusing on the incidence and surgical management of syndactyly. In this study, we describe the incidence and rates of surgical management of patients with syndactyly in New York State.AIMTo describe the incidence and surgical management of patients with syndactyly using an America's population-based database.METHODSWe conducted a retrospective study using the New York State Statewide Planning and Research Cooperative System. All patients with a diagnosis of syndactyly at birth were identified and followed longitudinally to determine yearly incidence as well as demographic and surgical factors. Descriptive statistics and univariate analyses were used.RESULTSThere were 3306 newborns with a syndactyly diagnosis between 1997 and 2014 in New York State. The overall incidence was 0.074% or 7 cases per 10000 live births. A small number of patients underwent surgical correction in New York State (178 patients, 5.4%). Among the surgical patients, most of the operations were performed before the age of two (79%). Approximately 87% of surgeries were performed at teaching hospitals, and 52% of procedures were performed by plastic surgeons. Skin grafting was performed in 15% of cases. Patients having surgery in New York State were more likely to have Medicaid insurance compared to patients not having surgery (P = 0.02).CONCLUSIONSyndactyly occurs in approximately 7 per 10000 live births, and the majority of patients undergo surgical correction before age two. There may be several barriers to care including the availability of specialized hand surgeons, access to teaching hospitals, and insurance status.

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Section: Discussionmentioning

confidence: 97%

Epidemiology of syndactyly in New York State

Swarup¹,

Zhang²,

Do³

et al. 2019

WJO

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“…20 We used ICD-9-CM and ICD-10-CM, diagnosis codes to identify surgical complications, as defined by the Pediatric Health Information System and used in previous studies. [39][40][41] The complete list of ICD codes flagged as surgical complications can be found through the children's hospital association Web site. 42 In Supplemental Table 3, we include the ICD codes of findings that were flagged as surgical complications in our study population.…”

Section: Primary Exposurementioning

confidence: 99%

Economic Trends of Racial Disparities in Pediatric Postappendectomy Complications

et al. 2021

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BACKGROUND: Despite unparalleled advances in perioperative medicine, surgical outcomes remain poor for racial minority patients relative to their white counterparts. Little is known about the excess costs to the health care system related to these disparities. METHODS:We performed a retrospective analysis of data from the Nationwide Inpatient Sample between 2001 and 2018. We included children younger than 18 years admitted with appendicitis who underwent an appendectomy during their hospital stay. We examined the inflation-adjusted hospital costs attributable to the racial disparities in surgical complications and perforation status, focusing on differences between non-Hispanic white patients and non-Hispanic Black patients. RESULTS:We included 100 639 children who underwent appendectomy, of whom 89.9% were non-Hispanic white and 10.1% were non-Hispanic Black. Irrespective of perforation status at presentation, surgical complications were consistently higher for Black compared with white children, with no evidence of narrowing of the racial disparity gap over time. Black children consistently incurred higher hospital costs

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“…Частота синдактилії в загальній популяції становить 1 на 2 000-2 500 новонароджених, у 50 % із них виявляють двосторонню патологію [4][5][6][7]. Синдактилія в 10-40 % випадків є ізольованим аутосомно-домінантним спадковим захворюванням.…”

Section: вступunclassified

“…Синдактилія в 10-40 % випадків є ізольованим аутосомно-домінантним спадковим захворюванням. Синдромні прояви цієї хвороби пов'язані з багатьма генетичними порушеннями, до таких відносять: синдроми Poland, Apert, Holt-oram, Карпентера та вроджені амніотичні перетинки [1][2][3][4][5]. Здебільшого, за умов генетичного синдрому діагностують синдактилію І та ІІ, ІІ та ІІІ пальців [6].…”

Section: вступunclassified

Features of surgical correction of various forms of hand syndactyly in children. Retrospective study of own treatment experience

Harbuzniak¹,

Hrуtsenko²

2021

OTP

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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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Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

Abstract: 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.

Cited by 19 publications

References 58 publications

Epidemiology of syndactyly in New York State

Epidemiology of syndactyly in New York State

Economic Trends of Racial Disparities in Pediatric Postappendectomy Complications

Features of surgical correction of various forms of hand syndactyly in children. Retrospective study of own treatment experience

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