Toe transfer for congenital hand defects

Eaton, Charles; Lister, Graham

doi:10.1002/micr.1920120308

Cited by 39 publications

(45 citation statements)

References 109 publications

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“…However, since most flap designs do not mobilize beyond the middorsal or midpalmar lines the actual difference between necessary and available skin results in a 57% increase in surface area [5]. In the adult patients the tissue expanders were inflated up to 21 ml to gain enough skin for digital closure.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are some disadvantages of tissue expanders; as two-staged operations, the possibility of infection and exposure, and high cost. With standard grafting techniques, web creep is reported to occur in 7.5% to 60% of cases and as many as one-third of patients require correction of postoperative contractures [3,5,9,14]. We strongly recommend the use of tissue expanders in adult patients with syndactyly.…”

Section: Discussionmentioning

confidence: 99%

“…Full thickness or thick split thickness skin grafts from various donor areas are used on the interdigital sides of the fingers with various problems with skin graft take and contraction. Onethird of patients require secondary surgery for contracture correction, angulation and web creep [3,5,9,14].…”

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confidence: 99%

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The use of tissue expanders in syndactyly repair

1996

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The syndactyly repairs of 11 hands in seven patients (average age 20.4) who had simple complete syndactyly between the third and fourth fingers were done by the use of tissue expanders in order to obtain adequate skin closure. At the first stage, a wedge type, 7 cc tissue expander was placed beneath the dorsal skin of the syndactylous digits via a vertical dorsal hand incision under local anesthesia. Inflation was begun on the 15th postoperative day. After the inflation period (average 32 days), syndactyly repair similar to the Littler technique was performed using axillary block anesthesia. During the expansion period one tissue expander became exposed and this hand was repaired by the classical skin grafting technique. In the remaining ten hands the expanded dorsal skin ensured skin closure of the digits and web reconstruction without any need for skin grafting. No complications were encountered during the postoperative period. Active and passive abduction angles, tip-to-tip length, active range of motion of the digits, and two point discrimination tests were done at follow-up (average six months). The web appearances were normal in all patients. Active abduction angles and active range of motion of the digits was always normal at the third postoperative month. Two point discrimination was 8.7 mm on the interdigital sides of the digits and there was no tip-to-tip length differences of the digits. No contractures were seen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The use of tissue expanders in syndactyly repair

1996

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“…[1][2][3] The etiology of syndactyly can be broadly divided into either congenital or acquired, with the latter predominantly secondary to burns. Its classification is based on the degree of soft tissue and bony involvement.…”

Section: Introductionmentioning

confidence: 99%

“…[4] The current techniques available are based at the opening of the webspace with the purpose of obtaining a normal webspace while supplying adequate skin coverage for it. [1,[5][6][7] These surgical techniques can be classified into two types: those utilizing a local flaps alone and those that use skin grafting in addition to it. The latter technique is used especially in difficult cases of complete syndactyly to treat the fusion distal to distal interphalangeal joint.…”

Section: Introductionmentioning

confidence: 99%

Resolution of 2nd, 3rd or 4th interdigital space incomplete, simple syndactyly using a random vascularity flap

Llave¹,

Murat²,

Figueroa³

2017

PAR

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Genetic heterogeneity in type III familial cutaneous syndactyly and linkage to chromosome 7q36

Al‐Qattan

Shamseldin

Mazyad

et al. 2013

American J of Med Genetics Pt A

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The ZRS (zone of polarizing activity regulatory sequence) is a long-range limb-specific Sonic Hedgehog (SHH) enhancer. In humans, the ZRS is located in chromosome 7q36 within intron 5 of LMBR1; approximately 1 Mb telomeric of SHH. Point mutations and duplications of the ZRS lead to a variable phenotype of preaxial polydactyly/triphalangeal thumb, tibial hypoplasia, radial ray deficiency, and type IV familial syndactyly (syndactyly of all digits with polydactyly). The ZRS is conserved among mammals and fish and regulates the expression of SHH. In mice, the conserved ZRS within the Lmbr1 gene is found in chromosome 5. The Hammertoe (Hm) mouse mutants have a mutation in the Lmbr1 locus and show syndactyly of digits 2-5 without polydactyly. No previous reports have described isolated syndactyly without polydactyly to be related to the LMBR1 locus in humans. In this report, we describe a family with simple cutaneous syndactyly involving digits 2-5, without polydactyly which is consistent with the phenotype of type III syndactyly. The locus we identified on ch7q36.3 is syntenic to the Hm locus; and affected members of the family had a phenotype analogous to Hm. Hence, the type of syndactyly described in the current report may be equivalent to Hm mice.

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Toe transfer for congenital hand defects

Cited by 39 publications

References 109 publications

The use of tissue expanders in syndactyly repair

The use of tissue expanders in syndactyly repair

Resolution of 2nd, 3rd or 4th interdigital space incomplete, simple syndactyly using a random vascularity flap

Genetic heterogeneity in type III familial cutaneous syndactyly and linkage to chromosome 7q36

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