Poland Syndrome

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Topic updated on 02/24/13 11:02pm
Introduction
  • A congenital disorder characterized by
    • unilateral chest wall hypoplasia
      • due to absense of sternocostal head of pectoralis major
    • hypoplasia of the hand and forearm
    • symbrachydactyly and shortening of middle fingers q
      • result of absence or shortening of the middle phalanx 
      • simple complete syndactyly of the short digits
  • Epidemiology
    • 1 in 32,000 live births
    • occurs in 10% of syndactyly cases
  • Etiology
    • thought to be linked to subclavian artery hypoplasia
Presentation
  • Physical exam
    • extent of hand and chest involvement varies
    • chest deformities
      • hypoplasia or absence of the pectoralis major, pectoralis minor, deltoid, serratus anterior, external oblique, and latissimus  dorsi
      • Sprengel’s deformity
      • scoliosis
      • dextrocardia
      • absence or underdevelopment of the breast
    • hand deformities
      • syndactyly
      • hypoplasia or absence of metacarpals or phalanges
      • absence of extensors or flexor tendons
      • carpal coalition or hypoplasia
      • radioulnar synostosis
      • nail agenesis
Imaging
  • CT scan
    • will show absent perctoralis major 
Treatment
  •  Operative
    • syndactyly release
      • indications
        • performed in most patients
      • technique
        • complete syndactyly release produces skin deficiency that requires skin grafting
        • perform only one side of the digit at a time to avoid vascular complications
        • local flap is created for commisure reconstruction followed by interdigitating zigzag dorsal and palmar flaps along the medial and lateral aspect of the digit
Complications
  • Skin graft failure
  • Excessive tension
  • Improper flap planning
  • Digital artery injury
  • Web creep
  • Nail deformity

 

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(OBQ04.152) Syndactyly is associated with all of the following conditions EXCEPT? Topic Review Topic

1. Apert syndrome
2. Poland's syndrome
3. Holt-Oram syndrome
4. Carpenter syndrome
5. Tay-Sach's Disease

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