CC BY-NC-ND 4.0 · Indian J Plast Surg 2022; 55(01): 007-017
DOI: 10.1055/s-0041-1734579
CME Article

Symbrachydactyly

Govindasamy Balakrishnan
1   The Tamilnadu Dr. MGR Medical University, Chennai, India
,
S. Vijayaragavan
2   Department of Plastic, Hand and Microsurgery, Right Hospitals, Kilpauk, Chennai, India
,
Balakrishnan Somesh
2   Department of Plastic, Hand and Microsurgery, Right Hospitals, Kilpauk, Chennai, India
› Author Affiliations

Abstract

Symbrachydactyly is a rare congenital hand malformation in which a child is born with abnormally short digits that may be webbed, misshaped, or missing, and it is usually a unilateral condition. There is no standardized treatment algorithm for the management of symbrachydactyly. The function of the hand is often not adequate and requires early surgical intervention to restore useful prehension and appearance. This CME article presents a brief review of the embryology, history, classification and clinical presentation, and author's experience of treating 19 children with symbrachydactyly over 10 years. Creation of thumb web, lengthening of thumb, and creating an opposition post results in prehension of hand with an improved quality of life.



Publication History

Article published online:
01 November 2021

© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Sandzén Jr SC. Classification and functional management of congenital central defect of the hand. Hand Clin 1985; 1 (03) 483-498
  • 2 Blauth W, Gekeler J. [Morphology and classification of symbrachydactylia]. Handchirurgie 1971; 3 (04) 123-128
  • 3 Yamauchi Y, Tanabu S. Symbrachydactyly. In: Buck-Gramcko E. ed. Congenital malformations of the hand and forearm. London: Churchill Livingstone; 1998: 149
  • 4 Foucher G, Medina J, Pajardi G, Navarro R. [Classification and treatment of symbrachydactyly. A series of 117 cases]. Chir Main 2000; 19 (03) 161-168
  • 5 Langer JS, Manske PR, Steffen JA, Hu C, Goldfarb C. Thumb in the plane of the hand: characterization and results of surgical treatment. J Hand Surg Am 2009; 34 (10) 1795-1801
  • 6 Balakrishnan G, Vijayaragavan S, Balakrishnan S. Omega flap technique: revisiting conventional wisdom. Hand (N Y 2021; 1558944721990786
  • 7 Buck-Gramcko D. Symbrachydactyly: a clinical entity. Tech Hand Up Extrem Surg 1999; 3 (04) 242-258
  • 8 Miyawaki T, Masuzawa G, Hirakawa M, Kurihara K. Bone-lengthening for symbrachydactyly of the hand with the technique of callus distraction. J Bone Joint Surg Am 2002; 84 (06) 986-991
  • 9 Miyawaki T, Masuzawa G, Hirakawa M, Kurihara K. Bone-lengthening for symbrachydactyly of the hand with the technique of callus distraction. J Bone Joint Surg Am 2002; 84 (06) 986-991
  • 10 Mann M, Hülsemann W, Winkler F, Habenicht R. [Distraction osteogenesis is an effective method to lengthen digits in congenital malformations]. Handchir Mikrochir Plast Chir 2016; 48 (01) 48-52
  • 11 Goldberg NH, Watson HK. Composite toe (phalanx and epiphysis) transfers in the reconstruction of the aphalangic hand. J Hand Surg Am 1982; 7 (05) 454-459
  • 12 Nguyen ML, Jones NF. Undergrowth: brachydactyly. Hand Clin 2009; 25 (02) 247-255
  • 13 Garagnani L, Gibson M, Smith PJ, Smith GD. Long-term donor site morbidity after free nonvascularized toe phalangeal transfer. J Hand Surg Am 2012; 37 (04) 764-774
  • 14 Netscher DT, Lewis EV. Technique of nonvascularized toe phalangeal transfer and distraction lengthening in the treatment of multiple digit symbrachydactyly. Tech Hand Up Extrem Surg 2008; 12 (02) 114-120
  • 15 Jones NF, Hansen SL, Bates SJ. Toe-to-hand transfers for congenital anomalies of the hand. Hand Clin 2007; 23 (01) 129-136
  • 16 Kaplan JD, Jones NF. Outcome measures of microsurgical toe transfers for reconstruction of congenital and traumatic hand anomalies. J Pediatr Orthop 2014; 34 (03) 362-368
  • 17 Gilbert A. Toe transfers for congenital hand defects. J Hand Surg Am 1982; 7 (02) 118-124
  • 18 Richardson PW, Johnstone BR, Coombs CJ. Toe-to-hand transfer in symbrachydactyly. Hand Surg 2004; 9 (01) 11-18
  • 19 Eaton CJ, Lister GD. Toe transfer for congenital hand defects. Microsurgery 1991; 12 (03) 186-195
  • 20 Koskimies E, Lindfors N, Gissler M, Peltonen J, Nietosvaara Y. Congenital upper limb deficiencies and associated malformations in Finland: a population-based study. J Hand Surg Am 2011; 36 (06) 1058-1065