{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T21:55:11Z","timestamp":1776462911280,"version":"3.51.2"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Apert syndrome is a complex congenital syndrome that includes bicoronal craniosynostosis, craniofacial dysmorphologies, cleft palate, hearing loss, spina bifida occulta, cardiac anomalies, and affects the upper and lower extremities\u2014producing complex syndactyly in these patients. Management of the hands yields several challenges and mandates close follow-up to balance repair of complex polysyndactyly with other pressing interventions, such as posterior cranial vault distraction and surgical management of the airway. Our goals of therapy for the hands are to preserve 10 digits, provide sufficient soft tissue coverage, optimize hand function, and minimize the number of surgical interventions. Ideally, surgical management of the hand differences occurs between the ages of 9 months and 2 years, to optimize neurocognitive development. In complex syndactyly observed in patients with Apert syndrome, there are broad, conjoined nail plates that overlie the fused digits, and paronychia occurs frequently. Suppurative infections can delay definitive surgical intervention for the patient\u2019s complex syndactyly, and resolution of paronychia is critical. This study aims to propose an effective and safe technique to manage paronychia when it occurs in patients with Apert complex syndactyly and to mitigate the length of delay to definitive polysyndactyly reconstruction. In the context of these patients\u2019 need for multiple surgical interventions within the first few years of life, this strategy for preventing or mitigating paronychia can play an important role in streamlining their complex surgical management while avoiding multiple cancellations.<\/jats:p>","DOI":"10.1097\/bth.0000000000000295","type":"journal-article","created":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T20:43:34Z","timestamp":1588970614000},"page":"30-34","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Management of Paronychia in Patients With Apert Syndrome"],"prefix":"10.1097","volume":"25","author":[{"given":"Justine S.","family":"Kim","sequence":"first","affiliation":[{"name":"University of Pittsburgh Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Block","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Pittsburgh, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Zhu","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander J.","family":"Davit","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center"},{"name":"Children\u2019s Hospital of Pittsburgh, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,3]]},"reference":[{"key":"R1-20250512","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/01.bth.0000185378.87246.61","article-title":"Algorithm for treatment of Apert hand","volume":"9","author":"Guero","year":"2005","journal-title":"Tech Hand Up Extrem Surg"},{"key":"R2-20250512","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/00006534-195612000-00005","article-title":"Syndactyllism: results of zig-zag incision to prevent postoperative contracture","volume":"18","author":"Cronin","year":"1956","journal-title":"Plast Reconstr Surg"},{"key":"R3-20250512","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1055\/s-0036-1593478","article-title":"Syndactyly release","volume":"30","author":"Braun","year":"2016","journal-title":"Semin Plast Surg"},{"key":"R4-20250512","doi-asserted-by":"crossref","first-page":"878","DOI":"10.2106\/00004623-197052050-00003","article-title":"The hand and Apert's syndrome","volume":"52","author":"Hoover","year":"1970","journal-title":"J Bone Joint Surg Am"},{"key":"R5-20250512","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0094-1298(20)30827-0","article-title":"Syndactyly correction of the hand in Apert syndrome","volume":"18","author":"Zucker","year":"1991","journal-title":"Clin Plast Surg"},{"key":"R6-20250512","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/00006534-198602000-00020","article-title":"Early surgical intervention in Apert's syndactyly","volume":"77","author":"Barot","year":"1986","journal-title":"Plast Reconstr Surg"},{"key":"R7-20250512","first-page":"26","article-title":"Webbed fingers","volume":"18","author":"Flatt","year":"2005","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"R8-20250512","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.PRS.0000065908.60382.17","article-title":"Treatment of the hands and feet in Apert syndrome: an evolution in management","volume":"112","author":"Fearon","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"R9-20250512","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1097\/00006534-199705010-00031","article-title":"The Apert syndrome hand: pathologic anatomy and clinical manifestations","volume":"99","author":"Holten","year":"1997","journal-title":"Plast Reconstr Surg"},{"key":"R10-20250512","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0094-1298(20)30826-9","article-title":"Apert syndrome. Classification and pathologic anatomy of limb anomalies","volume":"18","author":"Upton","year":"1991","journal-title":"Clin Plast Surg"},{"key":"R11-20250512","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1097\/PRS.0000000000004815","article-title":"Treatment of Apert hand syndrome: strategies for achieving a five-digit hand","volume":"142","author":"Raposo-Amaral","year":"2018","journal-title":"Plast Reconstr Surg"},{"key":"R12-20250512","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/00006534-200202000-00008","article-title":"Reconstruction of the hand in Apert syndrome: a simplified approach","volume":"109","author":"Chang","year":"2002","journal-title":"Plast Reconstr Surg"},{"key":"R13-20250512","first-page":"44","article-title":"Acute and chronic paronychia","volume":"96","author":"Leggit","year":"2017","journal-title":"Am Fam Physician"},{"key":"R14-20250512","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1038\/ejhg.2012.14","article-title":"Syndactyly: phenotypes, genetics and current classification","volume":"20","author":"Malik","year":"2012","journal-title":"Eur J Hum Genet"},{"key":"R15-20250512","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1080\/21678707.2017.1335195","article-title":"Apert syndrome: the Paris and Rotterdam philosophy","volume":"5","author":"Driessen","year":"2017","journal-title":"Expert Opin Orphan Drugs"},{"key":"R16-20250512","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1097\/GOX.0000000000002230","article-title":"Hand function in Apert syndrome","volume":"7","author":"Raposo-Amaral","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R18-20250512","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1097\/SCS.0000000000002016","article-title":"Guideline for care of patients with the diagnoses of craniosynostosis: working group on craniosynostosis","volume":"26","author":"Mathijssen","year":"2015","journal-title":"J Craniofac Surg"},{"key":"R20-20250512","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1086\/656595","article-title":"Patient-associated risk factors for acquisition of methicillin-resistant Staphylococcus aureus in a tertiary care hospital","volume":"31","author":"Salangsang","year":"2010","journal-title":"Infect Control Hosp Epidemiol"},{"key":"R21-20250512","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/01206501-200506000-00027","article-title":"Cutaneous reactions to silicone","volume":"16","author":"Nelson","year":"2005","journal-title":"Dermatitis"}],"container-title":["Techniques in Hand &amp; Upper Extremity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BTH.0000000000000295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T16:08:48Z","timestamp":1747066128000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BTH.0000000000000295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,8]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/bth.0000000000000295","relation":{},"ISSN":["1531-6572"],"issn-type":[{"value":"1531-6572","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,8]]}}}