Syndactyly, a condition where fingers are fused or joined, is one of the most common congenital anomalies seen in children, occurring in approximately 1 in 2000 live births, with males more commonly affected than females. This condition often affects the fingers of the hand, but in some cases, it can involve the toes as well.
Syndactyly develops during fetal development when the baby’s hand initially forms as a paddle and later divides into individual fingers. The condition is primarily caused by a failure of apoptosis (cell absorption), which is essential for the separation of fingers. It is worth noting that syndactyly can have a genetic component, with 10 to 40 percent of affected children inheriting the condition from a parent.
The fingers most commonly affected by syndactyly, in decreasing order, are:
Syndactyly is diagnosed when a child is born with webbed or joined fingers. Prenatal diagnosis is possible through a level 2 ultrasound. X-rays are conducted to assess bone fusion. Syndactyly is categorized into:
Simple Syndactyly: Fingers are joined by skin and soft tissue only.
Complex Syndactyly: Skin and soft tissue involvement, along with fusion of underlying finger bones.
Complicated Syndactyly: Involves soft tissue and bone fusion, along with abnormal bone and ligament development.
The primary and often only treatment for syndactyly is surgery.
a) Creation of a web space between fingers,
b) Treating the lateral soft-tissue defects– by zigzag skin plasty
c) Skin grafting on less demanding parts of the fingers. Full-thickness skin graft is mostly used to cover the defect.
d) Separation of the fingertips –
The surgical approach to syndactyly involves the separation of conjoined skin and subcutaneous tissues while preserving nerve and vessel integrity. The procedure aims to create a web space between fingers, address lateral soft tissue defects using zigzag skin plasty, and perform skin grafting to cover the defects. Separating fingertips is also a key aspect of the procedure, allowing for improved function and aesthetics.
After surgery, the child is typically discharged within a day. Dressings are changed after 5 to 7 days with subsequent dressings every 3 to 4 days. Immobilization is advised for 6 weeks, followed by regular physiotherapy and night-time splinting for 3 months to prevent contractures and promote optimal recovery.
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Syndactyly in children is a congenital condition where fingers are fused or joined together. It differs from other congenital hand conditions in terms of its characteristic fusion of digits.
Syndactyly can result from genetic factors or occur spontaneously during fetal development. Contributing factors may include family history and underlying genetic mutations.
Symptoms of syndactyly may involve fused fingers, webbing between digits, and potential functional limitations. The specific symptoms vary based on the extent of fusion and the fingers involved.
Diagnosis typically involves a clinical examination by a pediatric specialist, with possible additional imaging studies, such as X-rays, to assess the extent of fusion and plan for treatment.
Kayakriti Clinic specializes in pediatric hand conditions, including Syndactyly, with a focus on surgical separation of fused fingers and post-operative care. Their approach includes a team of experts experienced in pediatric hand surgery.
Kayakriti Clinic offers a child-friendly environment and a patient-centric approach to syndactyly treatment, providing age-appropriate care, surgical correction, and follow-up to optimize hand function and appearance.
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