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Are surgeons adhering to age guidelines for congenital syndactyly reconstruction?
Corianne Rogers MD, Leah Moravec, Rachel Danforth MD, Joshua Adkinson MD
University
2019-02-07
Presenter: Corianne Rogers
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: William A. Wooden, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Introduction
Syndactyly reconstruction is generally recommended between 12 and 18 months old. The aim of this study was to determine whether surgeons are adhering to age guidelines and whether presence of complex chronic conditions or congenital syndromes affects age at first surgery for syndactyly.
Methods
We completed a retrospective review of 4,059 patients that underwent syndactyly reconstruction from 2004 to 2017 using the Pediatric Health Information System database. We identified patients by International Classification of Diseases (ICD) code-9 and ICD-10 for repair of syndactyly. We examined age at initial syndactyly procedure and presence of congenital syndrome or chronic disease process.
Results
Reconstruction was performed at 2.68 ± 3.42 years old in patients without congenital or chronic conditions. Patients with complex chronic conditions and congenital syndromes underwent reconstruction at 2.83 ± 3.44 and 2.84 ± 3.64 years of age, respectively. Age at time of surgery was found to be significantly different for those with complex chronic condition (p=0.011), but not for those with a congenital syndrome (p=0.156).
Conclusion
Age at initial surgery was significantly higher for patients with complex chronic conditions, but not for those with congenital syndromes. Potential risks of early anesthesia in children with complex chronic conditions likely explains hand reconstruction at an older age in these patients. Given the presumed safety of anesthesia at younger ages in otherwise healthy children, educational opportunities for pediatric hand surgeons with a focus on completing reconstruction and optimizing hand function at an earlier age should be considered.
