The Apert syndrome hand: Pathologic anatomy and clinical manifestations

Ian W R Holten*, A. Wayne Smith, Anthony J. Bourne, David J. David

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


The Apert syndrome hand demonstrates many typical clinical features including syndactyly, symbrachyphalangism, and growth disturbances. This is due to the grossly abnormal anatomy of both the skeletal and soft-tissue structures associated with a progressive disease process. This paper presents a clinical, radiologic, and histologic analysis of the Apert syndrome hand anatomy and correlates it with the clinical manifestations. It also links hand and craniofacial dysplasia to other regions of the skeleton as well as the overall disease process. From our analysis, we conclude that there is a genetic anomaly causing variable and uncoordinated differentiation of the mesenchyme at the time of embryologic separation into its various skeletal components, particularly in the distal limb bud and craniofacial skeleton. This disease process continues postnatally in endochondral bone growth center malformation and malfunction as well as ectopic cartilage ossification in soft tissues. We discuss the role of abnormal musculotendinous anatomy and altered biomechanical forces in relation to these processes.

Original languageEnglish
Pages (from-to)1681-1687
Number of pages7
JournalPlastic and Reconstructive Surgery
Issue number6
Publication statusPublished - May 1997


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