SYNDACTYLIA

From Big Medical Encyclopedia

SYNDACTYLIA (syndactylia; Greek syn together, with + daktylos a finger) — an union of two and more fingers among themselves.

Distinguish the inborn and acquired S. Vrozhdennaya S. meets on feet and brushes, sometimes at the same time, the linden is quite often combined with other malformations of top and bottom extremities, a backbone. At men inborn S. is observed twice more often than at women. In half of S.'s cases is bilateral, at unilateral S. the right and left extremities are surprised equally often.

Inborn S.'s origin is connected or with genetically put defect inherited from parents (the endogenous reasons) or with influence of harmful external factors in a so-called critical period (5 — the 7th week of development of a germ). In some cases S. arises under the influence of the combined influence of external and internal factors. Approximately in 10% of cases of S. its origin is not clear.

The acquired S. often is observed after thermal and chemical damages of a brush. Function of a brush and fingers at the acquired S. is sharply reduced or is absent completely since all fabrics of the damaged site of a brush are deeply surprised.

Fig. 1. The diagrammatic representation of a brush at a basal webby syndactylia II and III, IV and V fingers in combination with a full skin syndactylia III and IV fingers (a), an also at a trailer syndactylia of distal phalanxes II, III and IV fingers.

On the extent of an union of S. can be basal (an union of fingers within proximal phalanxes), incomplete (an union of a part of inner surfaces of fingers) and full — an union from proximal to distal (nail) phalanxes (fig. 1, a). Besides, S. can be trailer when all distal phalanxes grow together in the uniform block, without growing together in average or proximal phalanxes of fingers that more often happens at amniotic banners or otshnurovyvaniye at the level of distal phalanxes of fingers (fig. 1, b).

By the form the fabrics involved in an interdigital union distinguish webby, skin and bone forms inborn Page. At skin and especially webby forms C. functional capacity of fingers and a brush is practically not broken.

Fig. 2. The roentgenogram of a brush at a trailer bone syndactylia of the II—V fingers.

Inborn S.'s diagnosis is made during survey of the patient. At the same time measure the volume of movements and ability to hold objects all fingers, including accrete. Make a X-ray analysis of a brush for differential diagnosis of skin and bone S. At the last form bone unions between phalanxes of fingers (fig. 2) are visible.

Treatment

Treatment operational. At inborn S. operation is performed aged 5 — 7 years with use of various methods of skin plastics are more senior. After operation apply a rivanol-vaseline bandage for 6 — 7 days, place a brush in a plaster splint, in 3 weeks after operation appoint physical therapy.

Methods of recovery of fingers and a brush at the acquired S. generally the same, as at inborn. Widely apply Filatov's method — cutting out of a tubular skin stalk, to-ry use for closing of defect (see. Skin plastics ).

The forecast

the Forecast at inborn S. is usually favorable. Working capacity of persons from inborn S. is always reduced, especially at those, the Crimea was necessary to separate I, II and III fingers. The result of treatment by the acquired S. are less favorable.

See also Malformations .


Bibliography: Boychev B., Konfortn B. and Chokanov To. Operational orthopedics and traumatology, the lane with bolg., page 348, Sofia, 1962; M. V. and Dedov V. D Wolves. Children's orthopedics, M., 1972; The Multivolume guide to surgery, under the editorship of B. V. Petrovsky, t. 11, book 1, page 85, M., 1960; L about effler F., M a t z e n R. F. u. To n about f 1 e of E. W. Orthopadische Operationen, Bd 2, S. 556, B., 1971.


B. V. Gusev.

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