Syndactyly

What is syndactyly?

Syndactyly is a congenital condition that affects the fingers or toes, causing them to be webbed or fused together. It is a condition that is present at birth and can vary in severity, ranging from partial fusion to complete webbing. As a parent of a child with syndactyly, you may have questions about the causes, types, diagnosis, treatment options, and support available.

What causes syndactyly?

Syndactyly occurs during fetal development when the digits fail to separate normally. The exact cause of syndactyly is often unknown, but it is believed to involve a combination of genetic and environmental factors. It can occur as an isolated condition, known as nonsyndromic syndactyly, or as part of a larger syndrome, known as syndromic syndactyly. Nonsyndromic syndactyly is typically sporadic and not associated with other developmental abnormalities or medical conditions. Syndromic syndactyly, on the other hand, is often associated with genetic syndromes such as Apert syndrome, Poland syndrome, or Holt-Oram syndrome.

What are the different types of syndactyly?

Syndactyly can be classified based on the extent of fusion and the involved digits. The most common types include:

Simple Syndactyly: In this type, only the soft tissues, such as the skin, are fused, while the bones remain separate. It commonly affects the middle and ring fingers or toes and may involve varying degrees of fusion.
Complex Syndactyly: Complex syndactyly involves both soft tissue and bony fusion. The bones of the affected digits are fused together, resulting in more significant functional and cosmetic implications.
Complicated syndactyly: Complicated syndactyly occurs when the fusion of bones and soft tissue is combined with additional or abnormally located bones. This type is often associated with syndromic syndactyly and may involve a staged treatment approach.

Syndactyly can also be classified as either partial or complete depending on how far to the tip of the finger the fusion extends.

How is syndactyly diagnosed?

Syndactyly is typically diagnosed shortly after birth based on a physical examination. Your healthcare provider will assess the extent of fusion and determine if any further tests, such as X-rays or genetic testing, are necessary. Genetic testing may be recommended to identify any associated genetic syndromes.

What are the treatment options for syndactyly?

The treatment of syndactyly depends on several factors, including the severity, type, and functional impact of the fusion. The primary goals of treatment are to improve hand or foot function, enhance appearance, and ensure proper growth and development. The treatment options include:

Surgical Intervention: Surgery is the mainstay of treatment for syndactyly, particularly for cases involving significant functional impairment or cosmetic concerns. The surgical procedure aims to separate the fused digits and reconstruct the affected area. The specific surgical technique will depend on the type and extent of fusion, as well as the individual needs of your child. Skin grafts or local flaps may be utilized to cover the raw areas and promote healing.
Observation and Non-surgical Management: In mild cases of syndactyly with minimal functional limitations or in cases of other severe compounding medical issues, observation may be recommended. Regular follow-up visits will be scheduled to monitor growth and assess the need for any future intervention.

When should surgery be performed?

The majority of cases of syndactyly are treated between 1 and 2 years of age. This allows the child to grow in size decreasing the risk from both anesthesia and surgical complications while still allowing for treatment before any negative impact on hand function. In some cases, such as fusion of the thumb to the index finger, early intervention may be recommended to optimize hand or foot function and facilitate normal growth and development. Your healthcare team will assess the best timing for surgery based on your child's individual needs and overall health.

What can I expect after treatment?

Your child will typically be placed into a cast following surgery in order to protect the surgical site in the immediate postoperative period. Your child may experience some discomfort and swelling following the procedure, but these typically last for only 24-48 hours and are easily managed with over-the-counter pain medicines. The healthcare team will provide specific post-operative instructions to ensure proper wound care and rehabilitation. Regular follow-up visits will be scheduled to monitor healing, assess hand or foot function, and address any concerns or questions you may have.

Are there any potential complications?

As with any surgical procedure, there are potential risks and complications associated with syndactyly surgery. These may include infection, scarring, delayed wound healing, nerve or blood vessel injury, and recurrence of fusion. Dr. Daggett will discuss these potential complications with you and take appropriate measures to minimize risks.

Our Services