Syndactyly is a fusion of the soft tissue, skeletal, or both elements of adjacent digits.it is very common congenital hand deformity, 20% have a family history (autosomal dominant) and 50% are bilateral. It can be associated with syndromic conditions (such as Apert’s and Poland’s)

SYMPTOMS 

Fusion of fingers  (Middle-ring finger web is most commonly affected – 58% of cases, 27% ring-little finger web,  14% middle-index web and  1% thumb-index web)

Nail fusion (synonychia)

Associated limb, chest wall and foot abnormalities.

OPERATIVE PROCEDURE 

Aim to separate the digits, provide a lined commissure, and create minimal scarring.

The web is reconstructed with proximally based dorsal or volar flaps.  Dorsal and volar interdigitating flaps close defects along the borders of the digits. Skin (Full thickness skin grafts) may be required to resurface residual raw areas

FAQS

1. What are the most common complications?

Vascular compromise, infection, dehiscence, graft loss. Web space contraction (web creep). 

This complication can be easily avoided by performing surgery under loupes magnification, aseptic technique, and postoperative care and by performing operation by properly trained plastic surgeon.

2. How many surgeries will be necessary?

Usually, only one surgery is required for a syndactyly that affects only two fingers. However, very few patients require another surgery – most commonly to deal with web creep

3. What is the approximate duration of the procedure?

One to two hours, but it depends on the number of figures involved.

What setup is required for the procedure?

A patient is required for the procedure and usually the patient admits for one to two days.

 

Written by :  Dr. Afaq Saleem

Copyrights: Pakistan association of Plastic Surgeons