Syndactyly is a condition present from birth (congenital) characterized by webbed or conjoined fingers or toes. There are four different types of syndactyly that are distinguished by how the fingers or toes are joined together.
- Incomplete syndactyly — webbing or connection between adjacent digits that involves only part of the affected fingers or toes
- Complete syndactyly — fingers or toes that are joined all the way out to the fingertip
- Simple syndactyly — fingers or toes that are joined by skin and soft tissue only
- Complex syndactyly — fingers or toes in which the underlying bones are also joined together
- Complicated syndactyly — the fingers or toes are joined by underlying bones in a manner that is not side-by-side, such as on top of or beneath the other fingers or toes
The space between the middle and ring fingers is most commonly involved and in half of all cases both hands or feet are affected.
The main symptom of syndactyly is webbed fingers or toes. The condition can range from minor webbing at the base of the digits to being joined by underlying bones. Patients may also notice that the affected fingers or toes do not move well.
In some cases, syndactyly can be diagnosed during a prenatal ultrasound. After the child is born, the physician will perform a physical examination and discuss the symptoms with patients and their families in order to make a diagnosis. The physician will look for symptoms of other conditions that may be causing the syndactyly. X-rays may be used to see the bone structure of the hand or foot in order to determine how the digits are conjoined. Blood tests may also be performed to screen for genetic conditions.
If syndactyly is affecting the toes, no treatment may be needed because the condition rarely causes functional challenges. When the condition is affecting the fingers, surgery is used to separate the fingers and restore function. The surgical method used to address the condition will depend on the type of syndactyly the patient has and the fingers involved.
The general method for addressing conjoined digits is creating zigzag cuts along the webbing and then attaching the flaps of skin created by the cuts to the fingers. This method reduces the need for skin grafts, although those may be needed if there is not enough skin to cover the fingers. If this occurs, the skin is most often taken from the stomach or hip areas.
Surgery is generally performed early on, particularly for complex syndactyly, in order to minimize potential issues that may form among the conjoined digits as the child grows.
After surgery, protecting the hand in a cast is necessary to ensure the area heals properly. At a follow up visit the physician will remove the cast and fit a splint onto the affected fingers. Surgery performed in childhood may need to be adjusted for growth with touch-up surgery when the child is older. Physical therapy may be needed if several surgeries are performed
The knowledgeable and highly trained staff at the Hand Surgery Program will work with each patient to determine the best treatment option.