NOSOLOGY OF HAND DISEASES IN CHILDREN AND ADOLESCENTS OPERATED IN PROVISIONAL FACILITIES IN A MODEL HOSPITAL - PERNAMBUCO STATE, BRAZIL

Congenital syndactyly: case by case analysis of 47 patients

OBJECTIVE

To assess and report clinical data from patients with syndactyly.

METHODS

A retrospective review of 47 patients treated between April 2002 and April 2012.

RESULTS

Among the 47 analyzed patients, 33 (70%) were male and 14 (30%) female. The total number of syndactylies was 116. The right hand was affected in 19 patients (40%), the left hand in 12 (24%) and 31 (36%) were bilaterally compromise. Sixteen patients (34%) also presented genetic syndromes. Among the 31 (66%) patients without syndromes, 12 (39%) had isolated syndactyly and 19 (61%) presented association with other hand anomalies. The third web space was affected 45 (39%) times; the fourth, 35 (30%) times; the second, 22 (19%) times and the first web space 14 (22%) times. Simple syndactyly was found 68 (59%) times, complete syndactyly in 44 (65%) and incomplete in 24 (55%). Complex syndactyly was found 48 (41%) times.

CONCLUSION

The results in this study are similar to the literature. Epidemiological Study .

SUCCESS OF CONSERVATIVE TREATMENT OF TRIGGER THUMB IN CHILDREN AFTER MINIMUM FOLLOW-UP OF FIVE YEARS

Objective: The aim of this study was to evaluate the outcome of conservative treatment of trigger thumb in children, in order to discuss the real need for surgical release in these patients. Methods: This was a retrospective study on a group of children with trigger thumb who were treated conservatively by the same orthopedic surgeon with gentle manipulation at the time of the consultation and guidance on stretching to be performed at home. The cases were followed up for at least five years. Results: Thirteen thumbs in 11 children (seven boys and four girls) were treated. The mean age at the first consultation was 26.3 months (range: 11 to 36 months). The mean follow-up was 10 years (range: 5 to 16 years). Ten thumbs showed satisfactory results (77%): eight of these were diagnosed when the child was younger than two years of age. The mean time taken from diagnosis to clinical improvement was 20.8 months (range: 6 to 36 months). The three thumbs that required surgical treatment were diagnosed after the age of two years and six months. Conclusions: Conservative treatment of trigger thumb in children showed a high rate of success, especially in children who were diagnosed up to the age of two years. This is important information to be passed on to parents and may avoid unnecessary surgery in many cases.