Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2019; 10(11): 387-393
Published online Nov 18, 2019. doi: 10.5312/wjo.v10.i11.387
Epidemiology of syndactyly in New York State
Ishaan Swarup, Yi Zhang, Huong Do, Aaron Daluiski
Ishaan Swarup, Aaron Daluiski, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States
Yi Zhang, Huong Do, Healthcare Research Institute, Hospital for Special Surgery, New York, NY 10021, United States
Author contributions: Swarup I and Daluiski A designed this study, reviewed the data, and wrote the manuscript; Zhang Y and Do H extracted the data, performed data analysis, and assisted with manuscript preparation.
Institutional review board statement: This study was approved by the institutional review board of the Hospital for Special Surgery.
Informed consent statement: Not applicable (database study).
Conflict-of-interest statement: None of the authors have any relevant conflicts of interest related to this work.
Data sharing statement: No additional data are available.
STROBE statement: STROBE statement has been reviewed and adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Aaron Daluiski, MD, Doctor, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, United States. daluiskia@hss.edu
Telephone: +1-212-6061284 Fax: +1-212-2888260
Received: June 5, 2019
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
Processing time: 169 Days and 8.6 Hours
Abstract
BACKGROUND

There is paucity of literature focusing on the incidence and surgical management of syndactyly. In this study, we describe the incidence and rates of surgical management of patients with syndactyly in New York State.

AIM

To describe the incidence and surgical management of patients with syndactyly using an America's population-based database.

METHODS

We conducted a retrospective study using the New York State Statewide Planning and Research Cooperative System. All patients with a diagnosis of syndactyly at birth were identified and followed longitudinally to determine yearly incidence as well as demographic and surgical factors. Descriptive statistics and univariate analyses were used.

RESULTS

There were 3306 newborns with a syndactyly diagnosis between 1997 and 2014 in New York State. The overall incidence was 0.074% or 7 cases per 10000 live births. A small number of patients underwent surgical correction in New York State (178 patients, 5.4%). Among the surgical patients, most of the operations were performed before the age of two (79%). Approximately 87% of surgeries were performed at teaching hospitals, and 52% of procedures were performed by plastic surgeons. Skin grafting was performed in 15% of cases. Patients having surgery in New York State were more likely to have Medicaid insurance compared to patients not having surgery (P = 0.02).

CONCLUSION

Syndactyly occurs in approximately 7 per 10000 live births, and the majority of patients undergo surgical correction before age two. There may be several barriers to care including the availability of specialized hand surgeons, access to teaching hospitals, and insurance status.

Keywords: Congenital hand anomaly; Epidemiology; Incidence; Syndactyly

Core tip: There is paucity of literature focusing on the incidence and surgical management of syndactyly. In our study, we found the incidence of syndactyly to be 7 cases per 10000 live births in New York State, and the majority of patients underwent surgical correction before age two. Most patients did not receive surgical care in New York State, indicating there may be barriers to care such as the availability of specialized hand surgeons, access to teaching hospitals, and insurance status. Additional study is needed to better understand outcomes after surgical management of syndactyly.