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.
Syndactyly Procedure
Syndactyly Procedure
Syndactyly procedure is a surgical operation that aims to separate the fingers or toes that are abnormally fused or webbed together, a condition known as syndactyly. The procedure can improve the function, appearance, and range of motion of the affected digits. The procedure is usually performed under general anesthesia and may require one or more stages depending on the type and severity of the syndactyly.
The procedure involves making incisions along the digits and separating the skin and soft tissues, and sometimes the bones, that are joined together. The surgeon then reconstructs the web spaces between the digits using skin grafts or flaps from the sides of the digits or other parts of the body. The skin grafts or flaps are shaped in a zig-zag pattern to avoid longitudinal scarring and to create a natural-looking web space. The surgeon also repairs any nerves, blood vessels, tendons, or muscles that may be affected by the syndactyly. The digits are then immobilized with splints or casts to allow healing and prevent infection.
Syndactyly procedure is a relatively common and effective treatment for syndactyly, a condition that affects the fingers and toes. The procedure can separate the digits and restore their normal appearance and function. There may be some residual webbing, scarring, asymmetry, or stiffness of the digits, and the surgery may require multiple stages and revisions to achieve the best result.
Syndactyly Risks & Benefits
Some of the benefits of syndactyly surgery are:
It can improve the range of motion and mobility of the digits, allowing the child to perform various activities and tasks more easily and comfortably.
It can enhance the cosmetic appearance of the hand or foot, reducing the stigma or psychological distress that may be associated with having a visible difference.
It can prevent or correct complications that may arise from syndactyly, such as deformity, contracture, impaired growth, nail abnormalities, or loss of sensation.
Some of the risks of syndactyly surgery are:
It may cause bleeding, infection, scarring, or damage to the nerves, blood vessels, tendons, or muscles of the digits, which may require further treatment or revision surgery.
It may result in web creep, which is the recurrence of webbing between the digits due to the skin grafts or flaps stretching over time.
It may not achieve the desired functional or cosmetic outcome, and the child may still have some residual webbing, asymmetry, or stiffness of the digits.
It may have emotional or psychological impacts on the child and the family, such as anxiety, pain, or dissatisfaction with the results.
The patient may need to stay in the hospital for a few days after the surgery and have regular dressing changes and wound care.
Syndactyly surgery is a complex and individualized decision that depends on several factors, such as the type, severity, and impact of the syndactyly, the age and health of the child, the availability and expertise of the surgeon, and the preferences and expectations of the child and the family.
Syndactyly Recovery & Aftercare
Syndactyly recovery and aftercare are the processes of healing and rehabilitation that follow the surgical separation of the fingers or toes that are fused together. The recovery and aftercare may vary depending on the type and extent of the surgery, the age and health of the patient, and the individual response to the treatment. However, some general guidelines and steps are:
The patient may need to take pain medication and antibiotics to prevent infection and reduce inflammation.
The patient may need to wear splints or casts for several weeks to immobilize the digits and allow them to heal properly.
The patient may need to have physical therapy to restore the function and mobility of the digits, as well as to prevent stiffness, contracture, or web creep.
The patient may need to have follow-up visits and additional surgeries to correct any complications or residual deformities, such as bleeding, infection, scarring, nail abnormalities, or loss of sensation.
The patient may need to have psychological support and counseling to cope with the emotional and social impacts of the condition and the surgery, such as anxiety, pain, or dissatisfaction with the results.
The recovery period after the procedure may vary depending on the extent and complexity of the surgery.
Syndactyly surgery in Iran
Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are suffering from Syndactyly (born with fused or webbed fingers).
Cost of Syndactyly in Iran
Syndactyly is a common congenital hand difference that can affect the quality of life of the patients. The prevalence of syndactyly varies among different populations, but it is estimated to be around 1 in 2000 to 3000 live births. The most common type of syndactyly is the simple incomplete syndactyly of the second and third toes, which usually does not require surgical intervention. However, syndactyly of the fingers, especially the thumb, can impair hand function and appearance and may need corrective surgery.
The cost of syndactyly surgery depends on several factors, such as the type and complexity of the procedure, the surgeon's experience and reputation, the hospital's facilities and equipment, and the patient's insurance coverage and financial situation. In Iran, the cost of plastic surgery is much lower than in many other countries, due to the availability of qualified surgeons, the reasonable prices of accommodation, food, and transport, and the favorable exchange rate of the Iranian currency.
The average cost of syndactyly surgery in Iran ranges around 500-1500 USD, depending on the type and number of digits involved. This price includes the surgeon's fee, the hospital fee, the anesthesia fee, the preoperative and postoperative tests, the medications, and the follow-up visits. Iran is one of the destinations that offer high-quality and affordable syndactyly surgery for patients who seek medical tourism.