Surgical results from treating children with syndactyly through the collective effort system at “SOS Hand Recife” between 2005 and 2009

Abstract

Objectiveto evaluate the results from and parents’ satisfaction with treatment for children with syndactyly who were operated at the “SOS Hand Recife” hospital between 2005 and 2009.Methodsdata for assessing the results were gathered from the patients’ medical files. The subjective scores, which were ascertained prospectively, were as follows: greater than or equal to 9, good result; between 6 and 8, fair result; less than 6, poor result. The results were analyzed statistically. This study was approved by the institution's ethics committee.Resultsamong the 35 cases, 21 (60%) consisted of simple syndactyly and 14 (40%) were complex; 22 (62.8%) were boys and 13 (37.1%) were girls. The complex cases were predominantly among males. The main complications were infection (11.4%), bleeding (11.4%) and pain (8.6%). There were more complications in the complex cases (42.8%) than in the simple cases (33.3%). The mean scores from the parents’ subjective evaluations were as follows: 7.6 for esthetics (7.7 in simple cases and 7.3 in complex cases; 8.2 for function (8.6 in simple cases and 7.6 in complex cases); 8.3 for the parents’ general satisfaction level (8.6 in simple cases and 8.0 in complex cases); and 85.7% of the parents would recommend the surgery to others while 14.5% would not. A strong association was observed between the specialist's objective assessment and the scores given by the parents (p < 0.05).Conclusionthe surgical results from treating syndactyly presented differences between the simple and complex types, even though the parents’ esthetic evaluations and satisfaction were similar.

Epidemiology of syndactyly in New York State

“…Among the surgical patients, most of the operations were performed before the age of two, and a minority of patients needed skin grafting. While surgical release is the recommended treatment for syndactyly and re-operation rates are well-published[21-24], there is limited data on the rates of surgery. Due to the paucity of studies on rates of surgery, we are unable to compare our surgical rates to other populations.…”

The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report

“…Syndactyly can be a sequela of trauma such as burn, inflammation of infection to the interdigital area as reported by Kim and colleges and Kirkup and colleges, when bony fusion can occur following crush injury. 5,6,7 Loss of interdigital epidermal surface allowed healing with fusion of the adjacent tissues. However, it is difficult to perform flaps or grafts on interdigital areas between toes and the procedure usually requires hospitalization.…”

“…As a result, a skin graft may be needed to cover the bare area or sutures in the middle of the web space and lead to "web creep," which is secondary scarring inside web spaces that causes pain, limits toe and foot motion, and has poor cosmetic outcomes. 7,8,9 Luangjarmekorn and colleges hypothesize that foot and hand web spaces have different anatomical dimensions and need specific flap designs for web space reconstruction in each region. Most of the toe syndactyly cases need flap lengths of nearly the entire proximal phalangeal length (approximately 80% to 90% of the proximal phalangeal length).…”

“…9,10 Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. 4,[7][8][9][10][11][12] The surgical methods used for foot syndactyly were derived from those for hand syndactyly. 3,4 Conventional surgical treatment for syndactyly is performed using various plastic surgery techniques, which consist of division and reconstruction with a dorsal skin flap and a skin graft to cover the raw surface.…”

“…Full syndactyly with bony fusion can occur following crush injury as the cause of severe trauma. 5,6,7 We report this case because it is a rare case and there is no standard algorithm in dealing with acquired syndactyly, especially on the toes.…”