About Syndactyly
Syndactyly is caused when a fetus’s genes are disrupted while developing. Genes are the biological building blocks that parents pass down to their children. These genes contain instructions for the growth and function of each cell in the body. Genetic disorders that usually cause syndactyly:
What is Syndactyly?
Syndactyly is a congenital condition that affects the development of the fingers and toes. It occurs when two or more digits are fused together by skin or bone, or both. Syndactyly can be classified into different types based on the degree, pattern, and complexity of the fusion. The most common type is simple syndactyly, where only the skin is joined between adjacent digits. Complex syndactyly involves the fusion of bones as well as soft tissues. Complete syndactyly means that the digits are joined all the way to the tip, while incomplete syndactyly means that there is some separation along the length of the digits. Fenestrated syndactyly is a rare form where there are gaps or holes in the webbing of the skin.
The exact cause of syndactyly is not fully understood, but it is believed to result from a disruption in the normal process of apoptosis, or programmed cell death, that occurs during embryonic development. Apoptosis is responsible for separating the digits from each other around the ninth week of gestation. Syndactyly may occur sporadically or as part of a genetic syndrome, such as Apert syndrome or Poland syndrome. Syndactyly can also be associated with other anomalies of the hands or feet, such as polydactyly (extra digits) or ectrodactyly (missing digits).
The treatment of syndactyly depends on the type, severity, and functional impact of the condition. Surgery is the main option to separate the digits and restore their normal appearance and function. Surgery is usually performed in early childhood, between six months and two years of age, to prevent complications such as deformity, contracture, or impaired growth of the digits. The surgery involves cutting the skin and soft tissues, separating the bones if needed, and reconstructing the web spaces using skin grafts or flaps. The surgery may require multiple stages and revisions to achieve the best outcome. The recovery period may involve immobilization, dressing changes, physical therapy, and follow-up visits.
How is syndactyly treated?
To treat Syndactyly, surgery is needed to separate the fused digits. Most babies are treated for syndactyly when they’re around a year old. During the surgery the baby’s fingers or toes are separated, including fused bones and other tissue. A skin graft may be used to cover the separated digits. Patients may need to wear a splint or cast on their repaired hand or foot to support the divided fingers or toes. Your surgeon may suggest physical therapy to ensure the hand or foot has regained strength after surgery.
Good Candidate for Syndactyly
Syndactyly can be treated surgically by separating the digits and reconstructing the web spaces using skin grafts or flaps. However, not all cases of syndactyly require surgery, and some factors may influence the decision to operate or not.
Some good candidates for syndactyly surgery are those who have complex, complete, or fenestrated syndactyly, as these types may impair the growth, movement, or sensation of the digits. Moreover, surgery may be indicated for those who have syndactyly associated with other anomalies, such as polydactyly (extra digits) or ectrodactyly (missing digits), or as part of a genetic syndrome, such as Apert syndrome, Poland syndrome, or Holt-Oram syndrome. These cases may pose additional challenges or complications that require surgical intervention.
Another factor that may make someone a good candidate for syndactyly surgery is their age. Surgery is usually performed in early childhood, between six months and two years of age, to prevent deformity, contracture, or impaired growth of the digits. Surgery at this age also allows the child to adapt better to the changes in their hand or foot, and to benefit from the natural healing and growth potential of their tissues. However, surgery may be delayed or avoided if the child has other medical conditions that increase the risk of anesthesia or infection, or if the parents prefer to wait until the child can participate in the decision-making process.