Abstract
Introduction
The purpose of this study was to comprehensively evaluate syndactyly correction. Patient selection, complexity, technique and aftercare are compared with scar quality, web-creep, hand function and patient satisfaction.
Methods
49 syndactyly releases (in 32 patients between 1999-2010) attended evaluation clinics. Demographics, surgical technique (island web transfer, graft vs graftless) aftercare and complications were identified from case notes. Patient satisfaction was obtained via questionnaire.
Function was assessed by grip and pincer strength, range of motion, and age of developmental milestones. Where appropriate this was compared to the contralateral side.
Results
The mean age at presentation was 28 months (0 – 11yrs), follow up was 28 months (1m-11yrs) and age at operation was 30 months (2months – 14yrs). 92% of patients reported a high degree of satisfaction, and nine webs required revision. There was no significant difference between web abduction angle or tip-to-tip distance on the affected compared to the unaffected sides (p=0.56). There was no delay in reaching developmental milestones. Of the techniques used graftless techniques had a significantly better range of abduction. (p=0.047). Those grafted had less creep but more pigmentation and hair-bearing grafts.
Conclusion
To our knowledge this is the most extensive study that reviews patients with both simple and complex syndactyly. The study assessed objective outcome measures and provides data that will aid to further improvement of syndactyly sevices.
