Recently, Dr Landi reported outcomes using a new concept in the treatment of syndactyly.
This article describes the use of a hyalruonic acid scaffold to fill in the defects instead of skin grafting for syndactyly reconstruction. The results are very good. Article link This material has become available in the United States and I wanted to share a recent case of ours.
This one year old child has bilateral cleft hands and cleft feet. He has a complete, cutaneous (skin only) syndactyly of the ring and small fingers bilaterally.
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Cleft hand with ring/ small finger syndactyly |
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Cleft hand with ring/ small finger syndactyly, palm view |
In an effort to improve function and independence of the two fingers, he was brought to the operating room for bilateral syndactyly reconstruction. We discussed using skin grafts but elected to proceed with the hyaluronic acid scaffold. The 'hyalomatrix' works as a hydrophilic gel which allows cellular migration onto its 3D scaffold. Skin cells can then migrate to allow healing.
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Hyaluronic acid scaffold |
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Hyaluronic acid scaffold- shiny side later peels off. |
Here are a few pictures after the surgery.
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Syndactyly reconstruction with hyaluronic acid scaffold, palm view |
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Syndactyly reconstruction with hyaluronic acid scaffold, dorsal view |
Charles A. Goldfarb, MD
My Bio at Washington Universitycongenitalhand@wudosis.wustl.edu