Complex Syndactyly: Aesthetic and Objective Outcomes

Syndactyly Web Space Reconstruction Using the Tapered M-to-V Flap: A Single-Surgeon, 30-Year Experience

“…Thus, although our long-term follow-up cohort of patients had a complication incidence of 28%, that group of patients also has the greatest percentage of complicated and complex syndactylies, which historically have a higher average complication rate compared with simple syndactylies. 13 Alternatively, the lower complication incidence observed in patients with shorter follow-up also suggests that complications were not being accounted for. We think this scenario is less likely because there were no other pediatric hand surgeons in our geographic area outside our academic group, and unless the patient relocated, there were no other surgeons near them with whom they could follow up in the event of a complication.…”

Congenital Anomalies of the Upper Extremity

“…Many studies however have noted poorer outcome with complex syndactyly [ 159 , 180 ], most likely due to the challenging nature of the reconstruction. Goldfarb et al [ 181 ] found signifi cantly higher rates of joint deformity amongst complex repairs and a high likelihood of abnormal nail appearance. Overall reoperation rates are quoted as 10 % [ 164 ] but are up to 50 % higher in those with polysyndactyly [ 181 ].…”

“…Goldfarb et al [ 181 ] found signifi cantly higher rates of joint deformity amongst complex repairs and a high likelihood of abnormal nail appearance. Overall reoperation rates are quoted as 10 % [ 164 ] but are up to 50 % higher in those with polysyndactyly [ 181 ]. It is imperative that follow up should be continued until skeletal maturity to detect complications, particularly joint deformity, which may require arthrodesis.…”

“…Pax3 regulates the expression of c-met in myocytes [ 181 ], while AER-associated Fgfs via Fgfr4 signaling control Sf/Hgf expression and thus the migratory routes of myocytes [ 180 ]. Mice defi cient in c-met or Hgf expression lack migration and show a complete absence of limb musculature [ 178 , 182 ].…”

The preliminary outcome of syndactyly management in children with a new external separation device

“…0 represents soft web with abduction mirrors of the adjacent web or equivalent web on the other hand: 1 represents no web advancement, but thickening of the web with reduced span; 2 represents creep of the web to 1/3 of the distance between the base of the web and the proximal interphalangeal (PIP) joint crease; 3 represents creep of web to 2/3 of the distance between base of the web and PIP joint crease; 4 represents creep of the web to the PIP joint crease [5][6][7]. 0 represents soft web with abduction mirrors of the adjacent web or equivalent web on the other hand: 1 represents no web advancement, but thickening of the web with reduced span; 2 represents creep of the web to 1/3 of the distance between the base of the web and the proximal interphalangeal (PIP) joint crease; 3 represents creep of web to 2/3 of the distance between base of the web and PIP joint crease; 4 represents creep of the web to the PIP joint crease [5][6][7].…”