It is devastating to be suddenly deprived of all prehensile ability. I do not believe it kind or wise to simultaneously operate on both hands of either an adult or a child. Present-day surgical techniques have made obsolete old adages such as “Wait until the baby fat has gone” or “Do before 7 and revise at 14.” It should be explained to the parents that the timing and type of surgery must be related to the particular digits involved and the degree of completeness and complexity of the webbing. I believe the question should be not how soon the operation can be done but rather how late the functional demands of the hand will allow postponement of surgery. The timing of surgery is a problem-sometimes for the surgeon and always for the parents. Parents are frequently subjected to social pressure urging early separation, but this is not necessarily in their child's best interest. For an otherwise normal individual I believe this is unnecessary cruelty. Webbed fingers is an obvious physical defect, and individuals can and do, even in these times, go through life without having a separation of a syndactyly. I was surprised to find that I have incomplete webbing between my second and third toes and have been delighted to find it to be extremely common in friends, acquaintances, and succeeding generations of residents. This unimportant anomaly is inherited as a dominant trait, but sporadic cases are more frequent. This webbing between long and ring fingers is probably less common than a similar condition between the second and third toes. It seems reasonable that its lowest occurrence should be between the thumb and index fingers because of their gross difference in lengths. There is no known reason why over 50% of all webbing should occur between the long and ring fingers. The distribution of webbing between the digits varies, and the incidence is shown in Figure Figure2 2. Unilateral and bilateral cases occur about equally, and it is 10 times more common in whites than blacks. Syndactyly is thought to occur about once in every 2000 to 2500 births and is twice as common in males. Nearly 40% of these patients were known to have a family history of the disorder. Problems with acne are more likely, especially during puberty.In my personal series of over 3000 patients with congenital hand anomalies are more than 500 cases of true or isolated syndactyly. Hyperactive sweat glands may cause your child to sweat a lot, especially while sleeping. The smaller nose and airway passages may make breathing difficult. Children with Apert Syndrome are often inclined towards recurrent ear infections, which can lead to hearing loss. Problems can occur due to imbalance of the eye muscles. About 50% of children with Apert Syndrome are affected however, as the children grow older, they often catch up with their peers. About 30% of children with Apert Syndrome are affected. These conditions and their severity vary from patient to patient. More commonly though, it is a completely random occurrence.īesides the physical characteristics, other health risks are also associated with Apert Syndrome. It can be an inherited condition-a person with the condition has a 50% chance of passing this down to his or her children. There are no known causes or risk factors for Apert Syndrome. Most children with Apert Syndrome have some degree of webbing between the fingers or toes. The palate is often high and arched, and sometimes cleft palate occurs. The mid-face has a sunken-in appearance, the upper jaw slopes backward, lower teeth project in front of the upper teeth. The eyes of these patients appear to "bulge out" due to the fact that their skull base and mid-face fails to grow in a normal fashion.įace. The sutures most commonly affected are the coronal sutures, which extend from ear to ear. When the sutures fuse together while the brain is still growing, the head and face become misshapen. Patients with Apert Syndrome typically have premature fusion of multiple cranial sutures. Distortions develop when the bone sections of the skull (sutures) fuse together too early in the life of the baby. Apert Syndrome, a form of craniosynostosis, is a genetic condition primarily involving distortions of the head and face.
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