4.6 Review

Recent Advances in Syndactyly: Basis, Current Status and Future Perspectives

Journal

GENES
Volume 13, Issue 5, Pages -

Publisher

MDPI
DOI: 10.3390/genes13050771

Keywords

syndactyly; heterogeneity; incomplete penetrance; surgery; HOXD13

Funding

  1. National Natural Science Foundation of China [81571994, 81870432, 81570567]
  2. Natural Science Foundation of Guangdong Province, China [2020A1515010054]
  3. Li Ka Shing Shantou University Foundation [L1111 2008]

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This review article provides a comprehensive summary of recent knowledge in syndactyly, including genetic etiology, phenotypic and genetic heterogeneity, gene mutations, the role of HOXD13, and modern surgical techniques. It also proposes a procedure for genetic analysis to improve genotype-phenotype correlation in the future.
A comprehensive summary of recent knowledge in syndactyly (SD) is important for understanding the genetic etiology of SD and disease management. Thus, this review article provides background information on SD, as well as insights into phenotypic and genetic heterogeneity, newly identified gene mutations in various SD types, the role of HOXD13 in limb deformities, and recently introduced modern surgical techniques for SD. This article also proposes a procedure for genetic analysis to obtain a clearer genotype-phenotype correlation for SD in the future. We briefly describe the classification of non-syndromic SD based on variable phenotypes to explain different phenotypic features and mutations in the various genes responsible for the pathogenesis of different types of SD. We describe how different types of mutation in HOXD13 cause various types of SD, and how a mutation in HOXD13 could affect its interaction with other genes, which may be one of the reasons behind the differential phenotypes and incomplete penetrance. Furthermore, we also discuss some recently introduced modern surgical techniques, such as free skin grafting, improved flap techniques, and dermal fat grafting in combination with the Z-method incision, which have been successfully practiced clinically with no post-operative complications.

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