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Free fat graft for congenital hand differences
Toshihiko Ogino1, Daisuke Ishigaki, Hiroshi Satake
1Sapporo Hand Surgery and Congenital Hand Differences Center, Orthopaedic Hokushin-Higashi Hospital, Sapporo, Japan. hand@ogino1.com
Clinics in Orthopedic Surgery
|March 2, 2012
Summary
Free fat grafting effectively treats congenital hand differences like longitudinal epiphyseal bracket and Madelung deformity, especially when performed during growth. It also helps prevent bone reunion after osseous syndactyly separation.
Area of Science:
- Orthopedic surgery
- Plastic surgery
- Congenital deformities
Background:
- Free fat grafting is a recognized treatment for congenital hand differences.
- Limited reports exist on the long-term outcomes of this surgical approach.
- This study evaluates the efficacy of free fat grafts in treating congenital hand and foot anomalies.
Purpose of the Study:
- To investigate the outcomes of free fat grafting for congenital hand and foot differences.
- To assess the effectiveness of free fat grafts in correcting specific deformities.
- To determine the optimal timing and technique for free fat grafting in these conditions.
Main Methods:
- Free fat grafts were applied to 14 cases of longitudinal epiphyseal bracket, 3 wrists with Madelung deformity, and 5 cases of osseous syndactyly.
- Treatments included osteotomy, physiolysis, or separation of osseous syndactyly combined with fat grafting.
- Specific techniques varied based on the congenital difference being addressed.
Main Results:
- Significant improvement in lateral deviation was observed in longitudinal epiphyseal bracket cases (average improvement 12.2-20.6 degrees).
- Madelung deformity showed improvement in some cases, but outcomes were less favorable when surgery occurred after age 13.
- Free fat grafting helped prevent bone reunion in osseous syndactyly cases, with one instance of reunion reported.
Conclusions:
- Physiolysis and free fat grafting during the growth period are effective for correcting deviations in longitudinal epiphyseal bracket and Madelung deformity.
- Free fat grafting is beneficial in preventing bone reunion after osseous syndactyly separation when adequately placed.
- Optimal surgical timing and graft placement are crucial for successful outcomes in congenital hand and foot reconstructions.
