Synostosis of the ring-small finger metacarpal in Apert acrosyndactyly hands: incidence and treatment.

This study reports on the incidence of a synostosis between the ring-small metacarpal bases in patients with Apert syndrome and describes a technique to resect the synostosis and insert silicone sheets to improve hand function. Records of 9 patients (18 hands) were evaluated. Average age at follow-up was 9.5 years. Three relationships between the ring-small metacarpals were observed. Type I hands (22%) had no abnormal interconnections; type II hands (33%) possessed a synostosis since birth; type III hands (44%) did not possess a synostosis at birth, but one later developed at average age of 79 months. Total incidence of synostosis was 77%. Five patients underwent excision of the synostosis. At an average of 16 postoperative months, 4 of these patients experienced improvement in hand prehension. In patients with Apert syndrome, resection of abnormal interconnections between the ring-small metacarpals is highly recommended to improve hand prehension based on the high incidence of a synostosis in this region.
AuthorsK D Dao, A Y Shin, S Kelley, V E Wood
JournalJournal of pediatric orthopedics (J Pediatr Orthop) 2001 Jul-Aug Vol. 21 Issue 4 Pg. 502-7 ISSN: 0271-6798 [Print] United States
PMID11433164 (Publication Type: Journal Article)
Chemical References
  • Silicones
  • Acrocephalosyndactylia (complications)
  • Adolescent
  • Adult
  • Bone Wires
  • Casts, Surgical
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hand Strength
  • Humans
  • Incidence
  • Male
  • Metacarpus
  • Osteotomy (instrumentation, methods)
  • Silicones
  • Synostosis (classification, etiology, physiopathology, radiography, surgery)
  • Treatment Outcome

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