Progress in surgical strategies for treatment of simple congenital syndactyly: A systematic review
- 164 Downloads
Plenty of surgical strategies for treatment of simple syndactyly have been reported in the past decades. We are most interested in what progresses have been made over the recent 10 years. Our aim was to make a summary of the modified techniques that have been described in the last decade.
We reviewed English articles from PubMed and Chinese articles from CKNI and CQVIP published between January 2007 and December 2016. We limited the inclusion criteria to simple syndactyly and excluded complex, complicated, and syndrome-associated syndactylies.
We identified 1650 articles and selected 94 for inclusion. Almost half of the included papers proposed modified flaps for web reconstruction. In most cases, a zigzag incision and Buck-Gramcko flaps were still the first choice to separate the fused digits and create the nail folds. Several new donor sites were recommended for skin grafts and several substitute biomaterials were introduced to replace skin grafts. External fixator devices were applied in a wider range for desyndactylization. However, it was not considered to be superior to other graft-less strategies. Postoperative complications were discussed in most papers, but an effective strategy to eradicate these is lacking.
With the development of biomaterials and surgeon’s experiences, more and more modified techniques have been conceived. However, no specific technique can be announced to be superior to others. Furthermore, more sensitive outcome measures should be established, and relationship between operative procedures and postoperative complications should be further defined.
Level of evidence: not ratable.
KeywordsSimple congenital syndactyly Desyndactylization Web reconstruction Skin grafts
Compliance with ethical standards
Conflict of interest
Jia Tian, Till Wagner, Inge Hoevenaren, Tycho Wesselius, Arico Verhulst, and Dietmar Ulrich declare that they have no conflict of interest.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
- 14.Moher D, Shamseer L, Clarke M, et al PRISMA-P Group (2015) Preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P) 2015 statement. Syst Rev 4:1Google Scholar
- 33.Ni F, Mao H, Yang X, Zhou S, Jiang Y, Wang B (2015) The use of an hourglass dorsal advancement flap without skin graft for congenital syndactyly. J Hand Surg Am 40(1748–1754):e1Google Scholar
- 50.Duteille F, Truffandier MV, Perrot P (2016) Matriderm’ dermal substitute with split-thickness skin graft compared with full-thickness skin graft for the coverage of skin defects after surgical treatment of congenital syndactyly: results in 40 commissures. J Hand Surg Eur Vol 41(3):350–351PubMedCrossRefGoogle Scholar