Progress in surgical strategies for treatment of simple congenital syndactyly: A systematic review

Tian, Jia; Wagner, Till; Hoevenaren, Inge A.; Wesselius, T.S.; Verhulst, Arico C.; Ulrich, Dietmar

doi:10.1007/s00238-017-1386-8

Cited by 3 publications

(10 citation statements)

References 52 publications

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“…However, recently, more authors believe that patients with simple syndactyly involving only two fingers can be operated upon before the child is 18 months old. 5 Surgeons have reached a consensus that they should be separated earlier in cases in which border digits are involved, i.e., by six months. However, the anaesthetic risks are inversely proportional to the age of the patient.…”

Section: Discussionmentioning

confidence: 99%

“…However, if the angle of these flaps is too obtuse, the scar may become a straight line with growth leading to flexion contractures. 5 Furthermore, debulking of the flaps and subcutaneous tissue has been practised by some authors to cover the wound without skin grafts. 19 Niranjan et al, used a dorsal trilobed flap to create a new web and used a zig-zag flap for the coverage of fingers, leaving the fat between the flaps to dry out without using a skin graft for its coverage.…”

Section: Discussionmentioning

confidence: 99%

“…The most common of these classifies it as simple (skin and soft tissue syndactylized), complex (bone or joint along with soft tissue fused), complete (fingers are fused up to the tip), incomplete fingers are partially connected). 4,5 When more than two digits and various elements are fused, as in Poland and Apert syndrome, it is classified as "complicated syndactyly". 2 When syndactyly is associated with some syndrome-like Holt-Oram syndrome or ring constriction syndrome, it is syndromic syndactyly.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Outcomes Following Syndactyly Release with Grafts and Without Grafts

Mansoor

Ahmed

Hameed

2022

PAFMJ

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Outcomes Following Syndactyly Release with Grafts and Without Grafts

Mansoor

Ahmed

Hameed

2022

PAFMJ

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“…Simple syndactyly is usually repaired between 12 to 18 months of age, while complex syndactyly or simple syndactyly where fused digits have a significant difference in length should be repaired before six months of age [6,9,14,15]. If fused digits with a difference in length are not repaired in a timely fashion, this may cause a functional deformity due to asymmetrical growth [11,15]. An important consideration for deciding when to perform surgery on patients with syndactyly is determining when the patient will begin attending school.…”

Section: Timing Of Surgerymentioning

confidence: 99%

“…Ensuring that the patient has the proper function of digits (including the ability to grip and pinch) before school age is important for the development of not only their fine motor skills but also for psychosocial development; thus, all syndactyly release should be performed preferably before 24 months [16]. While surgery should not be delayed due to the risk of joint deviation, contracture, and web creep, performing surgery when the patient is too young increases the risk of anesthesia and scar contracture [4,15]. If syndactyly is bilateral, the surgery can occur at the same time [11].…”

Section: Timing Of Surgerymentioning

confidence: 99%

Syndactyly in the Pediatric Population: A Review of the Literature

Mahindroo¹,

Tabaie²

2023

Cureus

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Syndactyly is one of the most common congenital upper extremity deformities. Syndactyly can be described as either simple, involving just the skin and soft tissue, or complex, involving the phalanges. Additionally, syndactyly can be categorized as complete, involving the entire digit (including the nail fold), or incomplete, which does not involve the nail fold. Multiple familial or spontaneous genetic abnormalities can cause syndactyly, and these mutations typically involve the canonical wingless-type (WNT) pathway. Surgical repair of syndactyly is typically done between six to 18 months of age, depending on the type of syndactyly. Regardless of the classification of the syndactyly, the repair is performed before school-going age (except in the case of extremely mild or rare, extremely complex syndactyly).One or more imaging modalities are used to aid the surgeon in deciding the surgical approach for the syndactyly repair. The surgical plan must be clearly communicated with parents to manage expectations of aesthetics and function of the digits post-surgery. In brief, a syndactyly release surgery involves the creation of the web space using a geometrical design of the surgeon's choice, defatting of finger flaps, separation of the digits, and closure with absorbable sutures. However, the approach may vary depending on the patient.A "best" approach for rectifying the difference in surface area of separated versus fused digits has not yet been determined. While this was typically done using a skin graft, the use of alternative methods (most notably, using a synthetic dermal substitute or not using a graft at all and allowing the skin to heal with secondary intention) has been on the rise given the undesirable side effects of a graft. Less commonly, an external fixator can be used to expand soft tissue and skin. In the case of complete syndactyly, the Buck-Gramcko technique is most commonly used for nail flap reconstruction. Complications of the surgery include contracture, web creep, and the need for a second surgery. Thus, parents must be counseled in recognizing signs of complications.

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