Syndactyly is a congenital malformation which is characterized by impaired differentiation of upper extremity tissues. Surgical correction of syndactyly is aimed to achieve satisfactory cosmetic and functional result. Most often, elimination of the total syndactyly form of the fingers implies is achieved by techniques according to Flatt (1962), Cronin (1943), Gilbert (1986), Wood (1998), bone form requires usage of Buck-Gramko technique. Objective. To conduct a retrospective study of surgical treatment results in patients with various forms of hand syndactyly. Methods. The study included 84 patients (109 hands) with hand syndactyly who were operated during the period from 2012 to 2020 in the pediatric orthopedics clinic of the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. The mean age of patients was 6.5 years (1 to 16), 39 (46.4 %) boys and 45 (53.6 %) girls. Most often syndactyly of III–IV fingers (105 (96.3 %) hands) was managed by the Wood method, namely in 63 (60.0 %) hands and 8 (7.6 %) cases with severe bone forms were corrected by Buck-Gramko method. Rotational skin pieces Ghani and Buck-Gramko were used for surgical correction of I–II fingers syndactyly. Treatment results were evaluated by the Vancouver Scar Scale (VSS). Results. According to VSS, the treatment result was classified as satisfactory in 73 (67.0 %) hands. Complications were noted in 11 (10.1 %) cases: 2 patients (18.2 % of 11) with congenital amniotic membranes were found to have lysis of a free skin piece; 1 (9.1 %) after removal of the bony syndactyly form had deviation of the nail phalanx; 3 (27.3 %) with Poland-syndrome were shown to have scarring of the interdigital space; 5 (45.4 %) with a complex bony form of syndactyly further on developed pulling scars, which caused deformity of the fingers and resulted in a correction in the form of multistage Z-plastics. Conclusions. All the patients showed improvement in the function and cosmetic results of the hand at the end of treatment. The best results were obtained in the case of simple and total forms of syndactyly treated with Wood technique.
Correção cirúrgica da assimetria torácica na síndrome de poland / Surgical correction of thoracic asymmetry in poland syndrome
