Arch Hand Microsurg.  2023 Mar;28(1):39-42. 10.12790/ahm.22.0050.

Isografting of full-thickness skin to treat syndactyly in monozygotic twins with Apert syndrome: a case report

• Kim JY
• Park S
• Kim BJ

• KMID: 2540029
• DOI: http://doi.org/10.12790/ahm.22.0050

Abstract

Patients with Apert syndrome require repeated limb surgery due to their complex deformities. In this study, a full-thickness isograft was performed for the division of Upton type III hands in identical twins with Apert syndrome. Nine-month-old identical twins presented with Apert syndrome characterized by craniosynostosis, severe syndactyly of the hands and feet, and dysmorphic facial features. Division and full-thickness skin grafting were performed. The siblings were operated consecutively on the same day. Following surgery for the younger sibling, there was an excess of graft left unused. In contrast, the older sibling required an additional skin graft of 1 × 1 cm. Full-thickness skin was successfully transferred between the twins without any rejection as of a 2-month follow-up. Thus, full-thickness skin isografting between monozygotic twins with Apert syndrome was successfully implemented.

Keyword

Acrocephalosyndactylia; Syndactyly; Skin transplantation; Homozygote

Figure

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  Fig. 1. Preoperative photograph (A) and X-ray radiograph (B) of both hands.

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  Fig. 2. Residual skin of the younger sibling.

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  Fig. 3. Skin defect that remained after using all the harvested skin.

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  Fig. 4. Immediate postoperative photograph. Residual skin from the younger sibling was used in the third web space (black arrow).

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  Fig. 5. Postoperative photograph (day 5) after removing the tie-over.

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  Fig. 6. Postoperative photograph (2 months). (A) Top view of both hands. (B) Bottom view of the right hand. (C) The full-thickness skin isograft was well-taken, without rejection (arrow).

Reference

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