Syndactyly, also known as “webbed fingers”, is the most common congenital malformation of the hand due to the failure to separate the fingers during embryonic development, with an incidence of 1 in 2000. The majority of patients are epidemic and there is a genetic component. Syndactyly is most common in the middle and ring fingers, accounting for approximately 50% of cases.
Complete syndactyly is a condition in which the two fingers are joined together from the web to the tip of the finger; incomplete syndactyly is a condition in which the two fingers are joined together from the web to a point proximal to the tip of the finger. In simple syndactyly, only the skin and other soft tissues are bridged together; in complex syndactyly, the two fingers share bony structures. Complicated syndactyly is often combined with other deformities.
Timing of treatment: If surgery is not urgent for a juxtaposition between the webs of the 2nd and 3rd fingers only, it should be postponed until at least 18 months of age. It is best to complete the surgery before school age. While waiting for surgery, the parents of the child are encouraged to massage the finger webs to stretch the skin between the fingers to facilitate the surgery. If the fingers of different sizes are fully involved, whether simple or full juxtaposition, it is best to separate them within 6-12 months, otherwise angulation, rotation or flexion deformity may occur.
The surgery consists of 3 steps: 1) finger separation; 2) joint reconstruction; 3) skin reconstruction on the opposite edge of the finger.