Isografting of full-thickness skin to treat syndactyly in monozygotic twins with Apert syndrome: a case report

Patients with Apert syndrome require repeated limb surgery due to their complex deformities. In this study, a full-thickness isograft was performed for the division of Upton type III hands in identical twins with Apert syndrome. Nine-month-old identical twins presented with Apert syndrome characterized by craniosynostosis, severe syndactyly of the hands and feet, and dysmorphic facial features. Division and full-thickness skin grafting were performed. The siblings were operated consecutively on the same day. Following surgery for the younger sibling, there was an excess of graft left unused. In contrast, the older sibling required an additional skin graft of 1 × 1 cm. Full-thickness skin was successfully transferred between the twins without any rejection as of a 2-month follow-up. Thus, full-thickness skin isografting between monozygotic twins with Apert syndrome was successfully implemented.