Abstract
In view of the multiple malformations in patients with Apert syndrome, numerous operations need to be carried out on the skull, midface, jaws, hands and in some cases also feet. We describe here a simplified surgical approach to hand surgery that enables several operative steps to be performed during one session and thus reduces the total number of surgical interventions. After visualising with MSCT angiography the bone and soft-tissue malformations and blood vessels, the operation is planned carefully. Transection and removal of the bony and cartilaginous bridges between the symphalangeal fingers is followed by placement of silastic sheets between the separated fingers for a period of 2 - 3 weeks to help form well-vascularised tissue over the spongy bone, which is then covered by full-thickness skin graft to promote healing. Depending on the severity of the Apert hand, numerous surgical procedures can be performed together at one and the same session. This is a simplified method in which the thumb is also straightened either during the same intervention or at a later date. This approach is explained with the help of three of our cases.
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