Syndactyly

Syndactyly means fusion of fingers together. It is a congenital ( from birth) difference in development. Two or more fingers may be fused together. It requires separation by surgery to achieve normal function and growth of fingers. Surgery is usually performed between 2-5 years for optimum result. If there is fusion of the bones of fingers, early release is advised. If more than two fingers are involved completely, staged release of fingers is preferred .

In few children syndactyly may be part of syndromes . Eg : Acrosyndactily, Apert syndrome, Poland syndrome etc

It is often associated with fusion of finger tip or loss of fingers when amniotic fluid ( fluid inside the uterus at time of pregnancy ) bands injure the child in the foetal stage.

In 50% children both hands are affected. Associated with absent digits in 50%. Fingers may be fused only by skin or it can be complex; involving bone too.

Separation of fingers by surgery makes them independant and child achieves better functions.

There is difference in the growth of head, face and syndactyly (fusion of fingers or toes ).

Due to mutation of gene - Fibroblast growth factor receptor -2 ( FGFR-2) ; located in chromosome 10q.

There may be disturbances in the growth of shoulder or elbow, restricting their range of movements. Hand - Complex syndactyly of the index,long and ring fingers and a simple syndactyly between ring and little fingers. There may be associated thumb web contracture too. These contractures prevent the child from using hands for holding objects.

Goal of surgery is to complete separation of the digits and correct thumb deformity to allow growth and the development of function. Reconstruction of space between thumb and index finger is the first priority.