Fourth 30% second 15% Third 50% first 5% Abnormalities. Nails-N.V-skeleton-tendon Complete-...
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Transcript of Fourth 30% second 15% Third 50% first 5% Abnormalities. Nails-N.V-skeleton-tendon Complete-...
Syndactyly
Syndactyly Fourth 30% second 15% Third 50% first 5% Abnormalities. Nails-N.V-skeleton-tendon Complete- incomplete -Complex-Complitcated Third-w.s most-50% shaped-long-ring Pathology-calssification U shaped index small finger V 3-4 ANATOMY
PREOPERATIVE evaluation
The extent of the syndactyly-nail-other anomalies
Examination
shoulder- entire upper-limb
• hand
• chest wall and
• the feet
Management
cosmetic
functional
developmental on growing child
Timing of surgery
18 months The first procedure First and second Third and forth
Contraindications medical conditions that preclude surgery or
complex synd that risk future functional impairment with attempted separation
on occasion there are insufficient components in the fused mass to produce independent stable and Mobil digits ( central brachysynd or synpolydactyly
mild incomplete synd without functional impairment
Paronychial fold
COMPLICATIONS
V.A infection-Wound dehiscence- graft loss
OVER TIME→ WEB creep- joint contractures
Beaked nail deformity
joint instability
COMPLICATIONS
Special cases of synd
Acrosyndactyly
Aper’s syndrome
Symbrachydactyly
Poland syndrome