Webplasty using an external fixator for complex syndactyly caused by Apert syndrome

Area of Science:

• Plastic surgery
• Pediatric orthopedics
• Congenital hand anomalies

Background:

• Apert syndrome, or Apert hand, causes complex syndactyly requiring surgical correction.
• Webplasty, a surgical procedure, can address syndactyly by extending soft tissue.
• External fixators offer a method for soft tissue distraction.

Purpose of the Study:

• To evaluate the efficacy of webplasty without skin grafting for Apert hand.
• To determine if lateral soft tissue extension can be achieved without grafts.
• To assess the utility of a simple external fixator in this procedure.

Main Methods:

• Webplasty with lateral extension was performed at a single institution between 2015 and 2023.
• The study included four pediatric patients diagnosed with Apert hand, aged 1-3 years.
• A custom-made, small external fixator was utilized for all soft tissue extensions.

Main Results:

• Webplasty was successfully completed in all patients without the need for skin grafting.
• The procedure was finalized by the time the patients reached 5-6 years of age.
• The external fixator facilitated adequate soft tissue expansion for syndactyly correction.

Conclusions:

• Webplasty without skin grafting is a viable treatment option for Apert hand.
• Lateral soft tissue extension using a simple external fixator is effective.
• This technique offers a potential alternative to traditional skin grafting methods.