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This report retrospectively reviews presenting radiographs and surgical treatment
of 28 hands in 14 children with Apert acrosyndactyly with the purpose of developing
a classification system to describe the decision-making process used to determine
the type and staging of hand reconstruction. The average patient age at last follow-up
evaluation was 7 years (range, 3–17 years). Type I deformities (7 hands) had little
or no angular deformity at the metacarpopha-langeal (MP) joint; two-stage reconstruction
created a four-fingered hand. Type IIA deformities (11 hands) had mild MP joint angular
deformity and a more proximal complex syndactyly of the middle three digits; two-stage
reconstruction created a three-fingered hand with ray resection of the third digit.
Type IIB deformities (7 hands) had pronation of digit 2 superimposed on the thumb
and radial angulation at the MP joint of digit 2; two-stage reconstruction created
a three-fingered hand with ray resection of the second digit. Type IIC deformities
(3 hands) had supination of digit 4 superimposed on digit 5 with ulnar angulation
at the MP joint of digits 4 and 5; two-stage reconstruction created a three fingered
hand with ray resection of the fourth digit. This report presents a classification
system and four different treatment strategies based on presenting radiographs.
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References
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Article info
Publication history
Accepted:
September 15,
1996
Received:
March 7,
1995
Footnotes
*No benefits in any form have been received or will be received from a commerical party related directly or indirectly to the subject of this article.
Identification
Copyright
© 1997 The American Society for Surgery of the Hand. All rights reserved. Published by Elsevier Inc.
