Synostosis of the ring-small finger metacarpal in apert acrosyndactyly hands: Incidence and treatment

Khiem D. Dao, Alexander Y. Shin, Steve Kelley, Virchel E. Wood

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


This study reports on the incidence of a synostosis between the ring-small metacarpal bases in patients with Apert syndrome and describes a technique to resect the synostosis and insert silicone sheets to improve hand function. Records of 9 patients (18 hands) were evaluated. Average age at follow-up was 9.5 years. Three relationships between the ring-small meta-carpals were observed. Type I hands (22%) had no abnormal interconnections; type II hands (33%) possessed a synostosis since birth; type III hands (44%) did not possess a synostosis at birth, but one later developed at average age of 79 months. Total incidence of synostosis was 77%. Five patients under-went excision of the synostosis. At an average of 16 postoperative months, 4 of these patients experienced improvement in hand prehension. In patients with Apert syndrome, resection of abnormal interconnections between the ring-small metacarpals is highly recommended to improve hand prehension based on the high incidence of a synostosis in this region.

Original languageEnglish (US)
Pages (from-to)502-507
Number of pages6
JournalJournal of Pediatric Orthopaedics
Issue number4
StatePublished - Jan 1 2001


  • Acrosyndactyly
  • Apert syndrome
  • Silastic
  • Synostosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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