Treatment of Common Congenital Hand Conditions

Wang, Bin; Tian, Xuemei; Hu, Yong

doi:10.1016/j.cps.2019.03.009

Cited by 5 publications

(6 citation statements)

References 66 publications

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“…7 Every patient should be evaluated individually, and surgical treatment should be proposed only in cases where global hand function can be improved, such as in the reconstruction of functional and well-formed web spaces. 15 This is the reason syndactyly release was the most common intervention in our patients, as well as in McClure's series. 4 It should be noted that none of the Moebius-Poland syndrome patients underwent breast reconstruction, unlike most of our "simple" Poland syndrome cohort, probably due to the young age of the patients.…”

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 57%

“…10 Most centers operate extrapolating information developed for other patient populations. 15 The surgeon should remember that patients with Moebius syndrome may also present hypotonia and developmental delay of motor skills, therefore an intensive rehabilitation program should be initiated as soon as a diagnosis is made. 7 Every patient should be evaluated individually, and surgical treatment should be proposed only in cases where global hand function can be improved, such as in the reconstruction of functional and well-formed web spaces.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Hand Malformations in Patients With Moebius Syndrome and Their Management

Telich-Tarriba

Navarro-Barquin

Verdezoto-Gaibor

et al. 2021

Hand (New York, N,Y.)

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Background: Moebius syndrome is a disorder characterized by facial and abducens nerve paralysis. Patients can present a wide range of upper extremity malformations. Literature focused on orthopedic manifestations of Moebius syndrome shows variability in the prevalence and clinical presentation of upper extremity anomalies. The aim of this work is to evaluate the prevalence of upper extremity malformations in patients with Moebius syndrome, clarify its various clinical presentations, and present treatment strategies for their management. Methods: This is a retrospective, cross-sectional study including patients with Moebius syndrome and upper extremity malformations between 2012 and 2019. Data include demographic characteristics, Moebius syndrome subtype, type of malformation, affected extremity, and surgical procedures underwent. Quantitative data were recorded as mean (standard deviation [SD]), and qualitative data were expressed in terms of totals and percentages. Statistical association between Moebius syndrome subtype and development of upper extremity anomalies was evaluated using binary logistic regression. Results: Twenty-five out of 153 patients (16.3%) presented upper extremity malformations (48% male). Mean age of presentation was 9.08 ± 9.43 years. Sixty-eight percent of the malformations were unilateral. The most common presentations included Poland syndrome and simple syndactyly with 8 cases each (32%), followed by 5 cases of brachysyndactyly (20%), 3 cases of amniotic band syndrome (12%), and 1 case of cleft hand (4%). No statistical association was found between Moebius syndrome subtype and odds ratio for development of upper extremity anomalies. Thirteen patients (52%) underwent reconstructive procedures. Conclusion: Poland syndrome and syndactyly are the most common anomalies in patients with Moebius syndrome. Patients may present with a wide range of hand malformations, each patient should be carefully evaluated in order to determine whether surgical treatment is needed and to optimize rehabilitation protocols.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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Prevalence of Hand Malformations in Patients With Moebius Syndrome and Their Management

Telich-Tarriba

Navarro-Barquin

Verdezoto-Gaibor

et al. 2021

Hand (New York, N,Y.)

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“…Simple surgical treatment often results in recurrence. Adjuvant therapies, including intralesional steroid injection, pressure therapy, radiation, silicone and photoelectric treatment, have been advocated as early postoperative interventions (Al-Attar et al., 2006; Wang et al., 2019). Since most patients are children, radiation therapy is not indicated because of epiphyseal inhibition.…”

Section: Introductionmentioning

confidence: 99%

Surgical excision and skin grafting combined with intralesional injection of triamcinolone for the treatment of keloids after syndactyly release

Jiang

Zhou

Tian

et al. 2022

J Hand Surg Eur Vol

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The purpose of this study was to investigate the efficacy of surgery combined with triamcinolone acetonide injection in managing the difficult problem of keloid formation after syndactyly release. Twenty-two patients with keloid formation after syndactyly release were retrospectively reviewed. They were divided into a simple surgery group and a surgery plus injection group. Complications, web quality, scar score and satisfaction were assessed and compared. In the surgery plus injection group, three patients (3/13) experienced recurrence and ten webs were good, whereas in the simple surgery group, seven patients (7/9) experienced recurrence and five webs were poor. The mean Vancouver Scar Scale score was significantly lower (4.3 versus 7.8) and the mean Faces Questionnaire satisfaction score was higher (4.2 versus 2.6) in the surgery plus injection group. Combining surgical excision with early and repeated intralesional injection can achieve better results with low recurrence rate and side effects. Level of evidence: IV

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“…Two main surgical strategies exist for the correction of radial polydactyly (Wang et al., 2019): simple excision or thumb sharing procedures. In the former, the less dominant duplicate is excised and the dominant one is reconstructed and stabilized.…”

Section: Introductionmentioning

confidence: 99%

A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients

Fang

Chan

Zhou

et al. 2021

J Hand Surg Eur Vol

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Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results. Level of evidence: IV

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Treatment of Common Congenital Hand Conditions

Cited by 5 publications

References 66 publications

Prevalence of Hand Malformations in Patients With Moebius Syndrome and Their Management

Prevalence of Hand Malformations in Patients With Moebius Syndrome and Their Management

Surgical excision and skin grafting combined with intralesional injection of triamcinolone for the treatment of keloids after syndactyly release

A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients

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