Is it a congenital syndactyly? Syndactyly is one of the most common congenital malformations of the limbs, second only to polydactyly. It is characterized by the complete or incomplete joining of the tissues of two or more fingers. Syndactyly can occur as an independent condition or as one of the symptoms of other malformations. In a variety of hand dysplasia deformities, syndactyly is one of the important manifestations. Among split hand deformities, syndactyly is common, as well as polydactyly, short syndactyly, crossed syndactyly, circumferential stenosis of the limb combined with syndactyly, and spade hand. Syndactyly is also a symptom of many syndromes, and over 300 syndromes with syndactyly have been documented, the most common being Apert syndrome, Poland syndrome, fascicular syndrome, and multiple craniofacial syndromes. Clinical classification of congenital syndactyly: simple syndactyly and complex syndactyly according to the presence or absence of bony tissues; complete syndactyly and incomplete syndactyly according to the extent of connected tissues; simple syndactyly and syndactyly according to the presence or absence of other organ malformations. What are the causes of congenital syndactyly? The pathogenesis of congenital syndactyly is not fully understood. Approximately 10% of patients with congenital syndactyly have a family history of syndactyly, which is often characterized by syndactyly of the middle ring finger and syndactyly of the 2nd/3rd toes. The majority of syndactyly is not familial and is the result of a genetic mutation. What should I do if I have congenital syndactyly? Congenital syndactyly can only be treated surgically to improve the appearance and function of the hand. In general, syndactyly that severely affects the development of the fingers should be operated on within 6 months; bony syndactyly or other syndactyly that is expected to affect the development of the fingers should be operated on within 6 months because of the possibility of secondary deformities such as angular, rotational, and flexion deformities. In the case of bunion syndactyly, whether complete or incomplete, it can interfere with the development of hand function, so it is best to operate at about 6 months of age. In the case of unequal interphalangeal syndactyly, since the joints of these syndactyly are not in the same plane, surgery too late may affect the function of the hand and may lead to secondary deformities, so surgery should be performed as early as possible. Regardless of the type of syndactyly, if surgery needs to be delayed for some other reason, it should be done before school age, preferably before 2 years of age, as this is the critical period for fine motor development of the fingers. Early surgery facilitates the development of basic hand functions such as grasping and pinching, and ensures the normal development of hand bones and muscles, while also effectively preventing secondary deformities from occurring. Is skin grafting required for congenital syndactyly? During syndactyly, there is usually a skin and soft tissue defect at the opposite edge of the web of the finger. In order to avoid the need for skin grafting, the skin defect is usually covered by a dorsal metacarpal flap or adjacent dorsal finger flap. For complex complete syndactyly, there are still some defects that cannot be repaired by flaps, so skin grafting is still needed to achieve the surgical goal. However, skin grafting can lead to scarring of the donor area, hyperpigmentation and decreased sensory function in the recipient area, and there is a certain risk of necrosis of the graft. In order to solve these problems, we designed an artificial dermis-induced total skin regeneration method for the treatment of congenital syndactyly to achieve skin graft-free syndactyly. Artificial dermis-induced dermal split finger technique is suitable for all types of syndactyly and is more effective in the treatment of complex syndactyly. Previous experimental and clinical studies have demonstrated that artificial dermis-induced skin regeneration can repair large skin defects, and that the quality of locally regenerated skin is very similar to normal skin, except for the presence of linear scarring along the long axis of the trauma. After using this method for syndactyly, regular dressing changes and rehabilitation exercises can improve the postoperative appearance and function of the affected finger without leaving scars on other parts of the body. No Implantation and Finger Separation Case 1 No Implantation and Finger Separation Case 2 No Implantation and Finger Separation Case 3 No Implantation and Finger Separation Case 4 No Implantation and Finger Separation Case 5 Congenital concurrent deformity is an obvious defect of the hand, in addition to affecting the function of the hand, the deformed appearance of the hand will also have more or less psychological impact on the affected children, so the surgery should be performed at the earliest possible time when it is possible to do so. In general, as long as there are no problems with the method, anesthesia and the design and operation of the surgery, then the results of the surgery for syndactyly and syndactyly are usually satisfactory.