Introduction: Symbrachydactyly is a unilateral hand abnormality characterized by incomplete finger formation and rudimentary nubbins containing nail plate, bone, and cartilage. Surgical intervention typically targets web space contractures, digit instability, and pincer dysfunction. This study examines the relationship between the severity of symbrachydactyly and the choice of operative or nonoperative approaches.

Methods: A retrospective comparative analysis was conducted on patients diagnosed with symbrachydactyly at a pediatric referral center from 2005 to 2024. Collected data included demographics (age, sex, laterality), familial factors (congenital malformations, miscarriage history), medical history (associated syndromes, pregnancy complications), clinical and radiologic details of hand abnormalities (side, Blauth and Foucher classifications), and treatment modalities. Descriptive, comparative, and correlation analyses were performed across treatment groups.

Results: A total of 80 patients were analyzed (median age: 5.32 y, IQR: 1.8 to 8.8), including 47 males (58.8%) and 52 patients (65.0%) with left-sided involvement. Nonoperative treatment was provided to 61 patients (76.3%), while 19 (23.8%) underwent surgical interventions. Among the nonoperatively treated patients, 9 (14.8%) received prostheses. Prosthesis use was significantly associated with higher severity in the Blauth and Foucher classifications (P<0.001). No significant differences in the Blauth (P=0.14) and Foucher (P=0.22) classifications were observed between nonoperative and surgical groups. The Blauth and Foucher classifications showed no significant associations with syndromic involvement, pregnancy complications, miscarriage history, or in vitro fertilization (P>0.05). A correlation analysis showed that more severe involvement in both classifications was statistically associated with a higher likelihood of nonoperative management: Blauth (r=-0.253, P=0.031) and Foucher (r=-0.243, P=0.038).

Conclusions: This study demonstrates that surgical interventions benefit patients with milder forms of symbrachydactyly, while patients with more severe manifestations typically receive nonoperative management, including prosthetic solutions.

Level of evidence: Level III-retrospective comparative study.

Keywords: congenital abnormality; myoelectric prostheses; nonoperative treatment; surgical treatment; symbrachydactyly.

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简介： Symbrachydactyly 是一种单侧手部异常，其特征为手指发育不全及含有指甲板、骨骼和软骨的短小突起。手术干预通常针对指间蹼挛缩、手指稳定性差以及夹持功能障碍等问题进行。本研究探讨了 Symbrachydactyly 的严重程度与采取手术或非手术治疗之间的关系。

方法： 一项回顾性比较分析在2005年至2024年间于一家儿科转诊中心诊断为Symbrachydactyly的患者中进行。收集的数据包括人口统计学信息（年龄、性别、患侧），家族因素（先天畸形、流产史），医疗病史（相关综合征、妊娠并发症），手部异常的临床和影像学细节（患侧，Blauth 和 Foucher 分类），以及治疗方式。对各治疗组进行了描述性、比较性和关联性分析。

结果： 共80名患者被纳入分析（中位年龄：5.32岁，四分位数范围：1.8至8.8），其中47名为男性（占58.8%），52名患者的左侧行使受累（占65.0%）。非手术治疗提供给61名患者（占76.3%），而19名患者（占23.8%）接受了手术干预。在未接受手术的患者中，有9名（占14.8%）使用了假肢。假肢使用的显著关联在于Blauth和Foucher分类中的更高严重程度（P0.05）的显著关联。相关性分析显示，两个分类中更严重的参与与非手术治疗的可能性更高之间存在统计学上的显著关联：Blauth (r=-0.253, P=0.031) 和 Foucher (r=-0.243, P=0.038)。

结论： 本研究表明，手术干预对 Symbrachydactyly 较轻形式的患者有益，而对于更严重表现的患者通常采取非手术治疗，包括假肢解决方案。

证据水平： III级-回顾性比较研究。

关键词： 先天异常；肌电假肢；非手术治疗；手术治疗；Symbrachydactyly.