Management of syndactyly: a clinical study

Abstract

Background: Syndactyly is a congenital anomaly, basic principles of surgical release of syndactyly have been well established, each patient requires a thorough assessment of the soft-tissue and bony components in the syndactylized region. Reconstruction must be planned carefully when more than two digits are involved or when the syndactyly is a component of a systemic congenital syndrome. The aim of the treatment strategies for syndactyly is to separate the fused digits, create a functional hand, and produce an aesthetically acceptable web.Methods: The prospective clinical study is conducted in the Department of Plastic & Reconstructive surgery, between October 2016 to October 2018. Twenty six patients with congenital syndactyly and post burn syndactyly of fingers were included in this study.Results: There were no intra operative complications and no cases had any neurovascular compromise. Integrity of Dorsal and volar flaps, quality of scars, aesthetical aspects of fingers are reasonably good in almost all the cases that are operated in this study. Overall 97% of patients treated achieved good function and superior results following single surgery.Conclusions: Primary syndactyly is more common than secondary syndactyly. In this study the primary goal is separation of fused digits/toes and covering the web space with dorsal flap, and covering the separated digits/ toes with a graft and create a functional hand and produce an aesthetically web with fewest complications and fewest surgical corrections.

Congenital Right Hand Syndactyly in a child: Plain Radiographic Features and Case Report

“…Syndactyly occurs as a congenital anomaly due to failure of separation of fingers at the 6 th week of gestation, the fingers are webbed in-utero, these webs are separated by apoptosis, this is followed by skin recession that allow formation of digital interspaces, the complete interdigital spaces are formed at the end of the 6 th week of gestation [8].…”

“…Syndactyly is a congenital anomaly, with a strong familial tendency, most often bilateral and commonly seen in males and usually seen in the third web space. The congenital syndactyly can either be primary which occurs as a failure of differentiation or separation, the secondary form of congenital syndactyly occurs as an outcome of antecedent events and produced by refusion abnormality [8].…”

“…Association of syndactyly with syndromes is referred to as the syndromic form of syndactyly; some of the syndromes are Poland's, Cleft hand or Aperts [4,8].…”

“…The diagnosis of syndactyly follows a detailed clinical examination for proper classification of the syndactyly; this is often followed by plain radiography of the affected hand to rule out synostoses, hidden polydactylies and other skeletal deformities [4,8].…”

“…The main treatment of syndactyly is by surgical repair; these include separation of the fused digits, normal web spaces creation with achievement of normal function of the hand, and form an acceptable aesthetical web with minimal complication [8,13].…”