Correction of the Thumb in Apert Syndrome - Modified Dome Osteotomy and Bilobed Flap

Children with Apert syndrome have extensive malformations of the extremities and the head. The thumb in Apert syndrome is always short with radial deviation and the first web space is narrowed and flattened. These thumbs can be corrected in a simple manner by modified dome osteotomy of the proximal phalanx combined with soft tissue coverage using a bilobed flap with simultaneous widening of the first web space. A preoperative multi-slice computed tomography (MSCT) angiography scan helps in planning the surgical procedures. This article describes the surgical technique and the results in 6 hands of 3 children. The aim is to illustrate the correction of the axis and length of the thumb.