Comparison Between Surgical Techniques for Correction of Congenital Syndactyly: A Systematic Review and Meta Analysis

Abstract

This review aimed to assess which surgical technique has better outcomes to correct one of the most common congenital anomalies of the upper limb: syndactyly. The following databases were used in the search: PubMed, Embase, Cochrane (CENTRAL), LILACS, SciELO, Scopus and Web of Science, on October 27, 2022. Studies that described a surgical technique for correcting syndactyly and evaluated surgical complications were included. Studies about noncongenital or foot syndactyly were excluded. The risk of bias was assessed using a specific method for case reports. For synthesis of results, the characteristics of the studies and techniques were demonstrated by a qualitative analysis. Meta-analysis models were applied for complications, functionality, and aesthetic. 73 studies were included, of which 70 were series or case reports, 27 studies did not use skin grafts and 7 studies used external fixators. To evaluate functional results, 42 studies used only the surgeon’s opinion. Meta-analyses showed a higher incidence of scar defects when using skin grafts and of infection when using external fixators. There was no difference for web creep and readmission. Few studies evaluated results using the VSS scale, showing worse scar pigmentation when skin grafts were used, but there was no difference in other parameters (PROSPERO CRD42022368930).