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Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly

Syndactyly is one of the most common congenital limb malformations, second only to polydactyly. Syndactyly is treated with surgical intervention. During separation, free skin grafting or skin flap transplantation is required to allow for adequate skin closure. We introduce a novel application method...

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Autores principales: Li, Jin, Wang, Qin, Panayi, Adriana C., Wu, Mengfan, Tang, Xin, Hong, Pan, Ze, Renhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601664/
https://www.ncbi.nlm.nih.gov/pubmed/33654022
http://dx.doi.org/10.1097/BTH.0000000000000342
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author Li, Jin
Wang, Qin
Panayi, Adriana C.
Wu, Mengfan
Tang, Xin
Hong, Pan
Ze, Renhao
author_facet Li, Jin
Wang, Qin
Panayi, Adriana C.
Wu, Mengfan
Tang, Xin
Hong, Pan
Ze, Renhao
author_sort Li, Jin
collection PubMed
description Syndactyly is one of the most common congenital limb malformations, second only to polydactyly. Syndactyly is treated with surgical intervention. During separation, free skin grafting or skin flap transplantation is required to allow for adequate skin closure. We introduce a novel application method of the Pennig external fixation device for the management of pediatric syndactyly without skin grafting. The Pennig minifixator was used in syndactyly to expand the web space soft tissue in order to allow a Z-plasty to be performed in a second operation. All patients had developed sufficient skin tissue from the external fixation. No infection, cutaneous necrosis or nonunion was noted in any of the patients. All patients had a satisfactory outcome in terms of final appearance and digit function. On the basis of the principle of strain-stress, use of the Penning external minifixator allows development of sufficient tissue in the web space for a second phase of reconstruction in syndactyly. The need for skin grafting and risk of blood vessel damage were avoided in this study, and, the incidence of skin necrosis and scar formation was reduced. Both the patients’ families and our research members expressed high satisfaction with the postoperative function and appearance. Overall, application of the Pennig external fixation frame in our novel method is effective for the management of syndactyly and should be studied further. Level of Evidence: Level IV, case series.
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spelling pubmed-86016642021-11-19 Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly Li, Jin Wang, Qin Panayi, Adriana C. Wu, Mengfan Tang, Xin Hong, Pan Ze, Renhao Tech Hand Up Extrem Surg Techniques Syndactyly is one of the most common congenital limb malformations, second only to polydactyly. Syndactyly is treated with surgical intervention. During separation, free skin grafting or skin flap transplantation is required to allow for adequate skin closure. We introduce a novel application method of the Pennig external fixation device for the management of pediatric syndactyly without skin grafting. The Pennig minifixator was used in syndactyly to expand the web space soft tissue in order to allow a Z-plasty to be performed in a second operation. All patients had developed sufficient skin tissue from the external fixation. No infection, cutaneous necrosis or nonunion was noted in any of the patients. All patients had a satisfactory outcome in terms of final appearance and digit function. On the basis of the principle of strain-stress, use of the Penning external minifixator allows development of sufficient tissue in the web space for a second phase of reconstruction in syndactyly. The need for skin grafting and risk of blood vessel damage were avoided in this study, and, the incidence of skin necrosis and scar formation was reduced. Both the patients’ families and our research members expressed high satisfaction with the postoperative function and appearance. Overall, application of the Pennig external fixation frame in our novel method is effective for the management of syndactyly and should be studied further. Level of Evidence: Level IV, case series. Lippincott Williams & Wilkins 2021-03-01 /pmc/articles/PMC8601664/ /pubmed/33654022 http://dx.doi.org/10.1097/BTH.0000000000000342 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Techniques
Li, Jin
Wang, Qin
Panayi, Adriana C.
Wu, Mengfan
Tang, Xin
Hong, Pan
Ze, Renhao
Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
title Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
title_full Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
title_fullStr Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
title_full_unstemmed Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
title_short Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
title_sort novel use of pennig external fixation for the treatment of pediatric syndactyly
topic Techniques
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601664/
https://www.ncbi.nlm.nih.gov/pubmed/33654022
http://dx.doi.org/10.1097/BTH.0000000000000342
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