In patients with Apert syndrome, the hands demonstrate many disturbances of soft 
tissue and bony structures. These include a short thumb with radial 
clinodactyly, complex syndactyly with a bony fusion involving the index, long 
and ring fingers, symphalangism and simple syndactyly of the fourth web space. 
The soft tissue anomalies involve the intrinsic muscles, the extrinsic tendon 
insertions and the neurovascular bundles. We have reviewed 52 patients who 
underwent surgical reconstruction of their hands. The aim of this study is to 
propose a better surgical management in the light of recent publications and to 
improve our understanding of the syndrome, attempting to reduce the number of 
procedures and to select the best possible procedures for each patient.