A mom consulted me, she said that the baby is now ten months, the right hand is the little finger and ring finger together, has taken a film, the film found that the bones of the little finger and ring finger grow together. When is the best time for pediatric syndactyly surgery? Does the surgery require skin grafting? Surgery for syndactyly can be done when the baby is about six months old. This baby is now ten months old and needs to be operated on as soon as possible. Because the length of the little finger and the ring finger are different, if they are not separated as soon as possible, as the baby grows and develops, the ring finger will definitely be carried by the little finger and will grow out of place, so surgery as soon as possible is necessary to separate them in order to ensure that the baby’s fingers are not affected in terms of shape and function. Some parents say that it is too early to do the operation at six months, and the success rate of the operation will not be high? As a matter of fact, there is no difference in the success rate between surgery at around six months and at one or two years of age. Both surgeries can separate and straighten the baby’s joined fingers. When the bones are joined together, the joint capsule and ligaments around the baby’s fingers are incomplete. If the joint capsule and ligaments are not reconstructed by surgery as early as possible, the development of the baby’s fingers will definitely be affected. The problem of skin grafting for syndactyly surgery was indeed a problem in the past because skin grafting would have some problems such as skin necrosis, scar contracture, pigmentation, etc., which are beyond the control of our doctors. To put it simply, skin grafting is like planting a crop, how the crop grows after planting depends on the crop’s own growth ability. Of course, the problem of skin grafting for syndactyly is no longer a problem because of the Artificial Dermal Induction (ADI) technique, which eliminates the need for skin grafting for either type of syndactyly. The dermal-induced dermal graft-free technique is now well established and safe, and has a very high success rate. After the surgery, the baby’s fingers will be restored to their ideal shape and function. The picture below shows our treatment with the skin-less technique.