Abstract
Apert syndrome is one of the most challenging congenital hand disorders to treat due to the absence of skin and soft tissues and the complex osseous fusion morphology. In addition, hypoplasia of the digital arteries and abnormal bifurcations are also known, so it is not recommended to create all interdigital spaces in a single operation. Multiple surgeries are usually required. In this report, a two-stage interdigital reconstruction using adipose flaps was performed for syndactyly with Apert syndrome. The osseous fusion of the complex syndactyly was dissected and covered with adipose flaps simultaneously with the interdigital reconstruction of the simple syndactyly at the primary surgery. Six months later, the interdigital reconstruction of the complex syndactyly was performed. This method is considered to be easy to perform and useful for ensuring sufficient soft tissue thickness in the lateral nail fold and secure skin grafting.