@entity1 born with @entity4886 pose great challenges to the pediatric hand surgeon. Reconstructive dilemmas consist of shortened, deviated phalanges and extensive @entity272 following syndactyly release. We present a 10-year review of @entity1 with @entity4886 who were treated with a simplified surgical approach. Between 1986 and 1996, 10 @entity1 with @entity4886 underwent reconstructive surgery of their hands. The overall strategy involved early bilateral separation of @entity8668 at 1 year of age, followed by sequential unilateral middle syndactyly mass separation with thumb osteotomy and bone grafting as needed. In these 10 @entity1 , a total of 53 web spaces were released, 49 of which involved osteotomies for complex syndactyly. Only local flaps and full-thickness skin grafts from the groin were used in all cases to achieve soft-tissue coverage. To date, seven of the 53 web spaces have needed revision (revision rate, 13 percent). @entity45541 (nine opening wedge and two closing wedge) were performed. Bone grafts from the proximal ulna or from other digits were used in all cases. To date, none of these thumb osteotomies have needed revision. This early, simplified approach to the @entity154 of @entity4886 has been successful in achieving low revision rates and excellent functional outcomes as measured by gross grasp and pinch and by @entity1 and parent satisfaction.

Reconstruction of the hand in XXXX : a simplified approach.

@entity1 :: ('9606', 'Species') :: ['patients', 'Children', 'patient'] @entity154 :: ('MESH:D000013', 'Disease') :: ['complex hand anomalies'] @entity8668 :: ('MESH:D001882', 'Disease') :: ['syndactylous border digits'] @entity45541 :: ('MESH:D020436', 'Disease') :: ['Eleven thumb osteotomies'] @entity4886 :: ('MESH:D000168', 'Disease') :: ['Apert syndrome', 'Apert acrocephalosyndactyly'] @entity272 :: ('MESH:D012871', 'Disease') :: ['skin deficits']
@entity4886 :: (MESH:D000168,Disease) :: ['Apert syndrome']
