{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:44:54Z","timestamp":1782301494627,"version":"3.54.5"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>This study evaluated how Apert hand syndactyly presentations and reconstructive techniques influence reconstruction outcomes. All cases at a major paediatric hospital between 2007 and 2022 were analysed, including 98 web space reconstructions in 17 patients. Overall, 62% of hands developed complications and 15% required revision surgery. Upton hand type was significantly associated with postoperative complication incidence, specifically including range-of-motion deficits, flexion contracture, web creep and revision surgery. More severe syndactylies may benefit from additional measures to reduce complications. Rectangular commissural flaps showed 1.9 times greater complication risk than interdigitating triangular flaps, including 11.2 times greater risk of web creep. Zigzag volar finger flaps showed 1.8 times greater complication risk than straight-line incisions, including 3.8 times greater risk of web creep. Our study showed that interdigitating triangular commissural flaps and straight-line volar finger incisions are preferable to rectangular commissural and zigzag finger flaps in most cases of Apert hand syndactyly to minimize complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17531934231213516","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T09:59:53Z","timestamp":1700560793000},"page":"617-626","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and operative risk factors for complications after Apert hand syndactyly reconstruction"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2659-0964","authenticated-orcid":false,"given":"Holly","family":"Cordray","sequence":"first","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Graham","sequence":"additional","affiliation":[{"name":"Division of Plastic, Reconstructive, and Oral Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anchith","family":"Kota","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apurva S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Division of Orthopaedic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Chang","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Division of Plastic, Reconstructive, and Oral Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"},{"name":"Division of Orthopaedic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2731-5526","authenticated-orcid":false,"given":"Shaun D.","family":"Mendenhall","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Division of Plastic, Reconstructive, and Oral Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"},{"name":"Division of Orthopaedic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200202000-00008"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320420505"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-195612000-00005"},{"key":"e_1_3_4_5_1","first-page":"58","article-title":"Treatment timing and multidisciplinary approach in Apert syndrome","volume":"6","author":"Fadda MT","year":"2015","unstructured":"Fadda MT, Ierardo G, Ladniak B, et\u00a0al. Treatment timing and multidisciplinary approach in Apert syndrome. Ann Stomatol (Roma). 2015, 6: 58\u201363.","journal-title":"Ann Stomatol (Roma)"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182729f42"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000065908.60382.17"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-817891"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bth.0000185378.87246.61"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1999.90.3.0443"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2016.11.018"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002230"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004815"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416641590"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.03.050"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)30826-9"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(97)80170-0"}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934231213516","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17531934231213516","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934231213516","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:47:03Z","timestamp":1777502823000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17531934231213516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,21]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1177\/17531934231213516"],"URL":"https:\/\/doi.org\/10.1177\/17531934231213516","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,21]]}}}