Published online Nov 18, 2019. doi: 10.5312/wjo.v10.i11.387
Peer-review started: June 10, 2019
First decision: July 30, 2019
Revised: August 22, 2019
Accepted: September 15, 2019
Article in press: September 15, 2019
Published online: November 18, 2019
There is paucity of literature focusing on the incidence and surgical management of syndactyly. In addition, very few epidemiologic studies have used modern, statewide databases to understand the incidence of disease in the United States.
It is important to understand the incidence and surgical management of an important congenital hand anomaly. It is also important to understand rates of surgical management and potential barriers to care.
In this study, we describe the incidence and surgical management of patients with syndactyly in New York State using a statewide database. This study helps to identify the incidence of disease, rates of surgical management, and potential barriers to care.
We conducted a retrospective study using the New York State Statewide Planning and Research Cooperative System database. We identified newborn records with a diagnosis of syndactyly to determine annual incidence, and searched subsequent records to determine rates of surgical management. Descriptive statistics and univariate analyses were performed on demographic and surgical information contained in the database.
We identified 3306 cases of syndactyly between 1997 and 2014 in New York State. The overall incidence was 0.074% or 7 cases per 10000 live births. In total, 178 patients underwent surgical management in New York State and 79% of patients were under the age of two at the time of surgery. Approximately, 87% of surgeries were performed at teaching hospitals, and 52% of procedures were performed by plastic surgeons. Patients having surgery in New York State were more likely to have Medicaid insurance compared to patients not having surgery.
Syndactyly occurs in approximately 7 per 10000 live births, and the majority of patients undergoing surgical correction are treated before age two. There may be several barriers to care including the availability of specialized hand surgeons, access to teaching hospitals, and insurance status.
Additional research is needed to determine the incidence of syndactyly in other populations, understand the low rates of surgical management in New York State, and describe the outcomes of surgery in this population. Statewide databases are well-suited for these types of studies.