Syndactyly correction of the hand in Apert syndrome.
Surgical correction of syndactyly of the Apert hand should begin by 6 months and be completed by 3 years of age. As much surgery as possible is carried out at each sitting. Digit separation should be in order of functional importance. The first web space is deepened with a four-flap Z-plasty or a dorsal skin flap from the web and index finger. Syndactyly release using a dorsal flap and zig-zag technique is used to create the second and fourth web spaces. The complex long-ring syndactyly often requires a pedicled groin flap for reconstruction and preservation of growth potential. A five-digit hand can be achieved with adequate grasp and stable, sensate, well-aligned digits. These children can attain some degree of independent finger motion and aesthetically acceptable hands with this approach.
Zucker
R M
RM
University of Toronto, Ontario, Canada.
Cleland
H J
HJ
Haswell
T
T
D000168:Acrocephalosyndactylia / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006228:Hand Deformities, Congenital / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D011859:Radiography; D013576:Syndactyly / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors