Особливості хірургічної корекції різних форм синдактилії кистей у дітей. Ретроспективний аналіз власного досвіду лікування
Bibliographic record
Abstract
Syndactyly is a congenital malformation which is characterized by impaired differentiation of upper extremity tissues. Surgical correction of syndactyly is aimed to achieve satisfactory cosmetic and functional result. Most often, elimination of the total syndactyly form of the fingers implies is achieved by techniques according to Flatt (1962), Cronin (1943), Gilbert (1986), Wood (1998), bone form requires usage of Buck-Gramko technique. Objective. To conduct a retrospective study of surgical treatment results in patients with various forms of hand syndactyly. Methods. The study included 84 patients (109 hands) with hand syndactyly who were operated during the period from 2012 to 2020 in the pediatric orthopedics clinic of the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. The mean age of patients was 6.5 years (1 to 16), 39 (46.4 %) boys and 45 (53.6 %) girls. Most often syndactyly of III–IV fingers (105 (96.3 %) hands) was managed by the Wood method, namely in 63 (60.0 %) hands and 8 (7.6 %) cases with severe bone forms were corrected by Buck-Gramko method. Rotational skin pieces Ghani and Buck-Gramko were used for surgical correction of I–II fingers syndactyly. Treatment results were evaluated by the Vancouver Scar Scale (VSS). Results. According to VSS, the treatment result was classified as satisfactory in 73 (67.0 %) hands. Complications were noted in 11 (10.1 %) cases: 2 patients (18.2 % of 11) with congenital amniotic membranes were found to have lysis of a free skin piece; 1 (9.1 %) after removal of the bony syndactyly form had deviation of the nail phalanx; 3 (27.3 %) with Poland-syndrome were shown to have scarring of the interdigital space; 5 (45.4 %) with a complex bony form of syndactyly further on developed pulling scars, which caused deformity of the fingers and resulted in a correction in the form of multistage Z-plastics. Conclusions. All the patients showed improvement in the function and cosmetic results of the hand at the end of treatment. The best results were obtained in the case of simple and total forms of syndactyly treated with Wood technique.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.018 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".