How to Treat Complicated Fingers

  Syndactyly is a common congenital deformity of the hand, manifested by the fusion of adjacent fingers into one. According to the number of affected fingers, it can be divided into: two fingers and multiple fingers; according to the number of fingers and tissues, it can be divided into: complete and incomplete syndactyly; according to the composition of the syndactyly, it can be divided into: simple soft tissue syndactyly, bony syndactyly; there are also complex syndactyly with tendon and bone joint abnormalities, etc. The syndactyly often exists together with other hand and foot deformities such as syndactyly, polydactyly, short finger deformity, missing finger deformity and girdle syndrome. Some syndactyly is a manifestation of some specific syndromes, the most common being poland syndrome (Poland syndrome) in which the ipsilateral pectoralis major muscle is hypoplastic or absent, and the rare Apert syndrome (acromion syndrome).  Treatment of congenital syndactyly requires surgical separation. The timing of surgery varies widely in China and abroad. In China, the old concept is that the operation should be performed after 3 years of age until preschool age, because the tissue structure of infants and children is small and not easy to separate, which may cause the operation to fail. However, with the development of hand and foot microsurgery and the improvement of surgical techniques, the international concept advocates early surgery, generally starting at the age of half a year. Because the fine motor development of the hand starts from 3 months, and by 3 years old, the fine motor development of the hand has been completed. Therefore, early surgery so that the child has a pair of normally moving fingers is beneficial to the development of the child’s hand fine motor. Simply put, early surgery can make a child’s hand more flexible in the future and can be good at some manual fine occupations. In particular, thumb and index finger, ring finger and pinky finger juxtaposition, as well as juxtaposition with bony connection, need early surgery to separate, otherwise finger deformity will increase with age, and some finger scoliosis surgery is difficult to correct at a later stage.  The method includes three main steps: finger separation, web formation, and trauma repair.