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

Abstract

SUMMARY:

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.

• Authors: K D Dao, A Y Shin, S Kelley, V E Wood
• Journal: Journal of pediatric orthopedics (J Pediatr Orthop) 2001 Jul-Aug Vol. 21 Issue 4 Pg. 502-7 ISSN: 0271-6798 [Print] United States
• PMID: 11433164 (Publication Type: Journal Article)

Chemical References

• Silicones

Topics

• Acrocephalosyndactylia (complications)
• Adolescent
• Adult
• Bone Wires
• Casts, Surgical
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Hand Strength
• Humans
• Incidence
• Male
• Metacarpus
• Osteotomy (instrumentation, methods)
• Radiography
• Silicones
• Synostosis (classification, diagnostic imaging, etiology, physiopathology, surgery)
• Treatment Outcome