Syndactyly and Brachysyndactyly

Syndactyly is one of the most common congenital hand anomalies with the simple form of syndactyly affecting one in every 3000 new born. The expression comes from the Greek words “syn“– together and “daktylos” - finger. This anomaly is the growing together of two or more fingers. In extreme cases all of the fingers of the hand are affected, which is often known as spoon or mitten hand. Commonly affected on the hand is the third web space between the fingers, and on the feet it is the second space between the toes. The fingers can be joined by soft tissue only, which is known as cutaneous syndactyly or simple syndactyly. However, in the osseous from of syndactyly the fingers have a bony joining. The mobility of the fingers is limited. If all fingers are affected then the hand cannot perform a normal gripping function. Besides the fingers being joined, they are often shorter, which is known as brachysyndactyly. These anomalies usually develop spontaneously during 5-7 weeks of pregnancy. There is an above average number of cases in children with triploidy, and syndromes such as Apert, Aarskog, Fraser, Holt-Oram or Adams-Oliver.

The time point for the operation should be in the period between turning two years old and the end of the second year. This all depends on the extent of the anomaly and resulting limitations in hand function as well as additional accompanying anomalies. An operation should be performed if there is considerable size difference in the affected fingers and to prevent joint disorders and incorrect growth. An additional skin transplant is usually required for the areas separated during surgery. The hand is immobilized in a cast for 10 days after surgery. The removal of sutures often has to be carried out under a short-acting anaesthetic.

Syndactyly and brachysyndactyly are congenital anomalies.
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