SYNDACTYLY - joined together

Syndactyly, or "webbed fingers," is caused by the failure of the fingers to separate during embryological development. It is the most common congenital anomaly of the hand, with an occurrence of 1 per 2000 births. Hereditary causes has been suggested, with up to 40% of patients having a positive family history of syndactily.

Syndactyly can also be associated with a variety of other syndromes, some of them rare - for example in the patient below with Apert Syndrome.

Syndactyly in an infant - part of a larger problem - the Apert Syndrome

Syndactyly is most commonly seen in the middle and ring fingers; it can be classified as simple when it involves soft tissues only and complex when it involves the bone or nail of adjacent fingers. It can also be classified as complete or incomplete depending on the degree of soft tissue union between the fingers.

Timing of separation of the digits depends on the fingers affected. If the affected digits grow at unequal lengths (for example the little and ring fingers) then separation should ideally be done within the first few months of life as the tethering of the skin will cause the fingers to deviate and cause contractures.

Ring and mddle finger syndactyly usually does not pose functional problems, as in the case of the older child below. In this case, it is a simple, complete syndactyly of the ring and middle fingers. Since both fingers grow at equal lengths, surgery to separate the fingers can be delayed later in life.

- the BomohTulang -