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Syndactyly is a medical condition where fingers or toes have a web in between them, often due to genetic factors. It is the most common congenital hand symptom, occurring in one in 2,500 births. Corrective surgery is usually performed when the child is five to six months old or between one and two years old. The prognosis is excellent in isolated cases, but in cases where it is part of a syndrome, the results will depend on the general condition of the child.
Syndactyly comes from the Greek words syn, meaning “together” and daktulos, meaning “finger.” It is a medical term that refers to a condition in which the toes, fingers or both have a web in between that joins them together, most often due to genetic factors. In most cases, the texture in syndactyly is just skin, but in some cases the bones of two fingers may be fused together. Syndactyly is the most common congenital hand symptom, occurring in one in 2,500 births, and is often first noticed when a newborn is examined after birth.
This condition occurs more often in males than in females, and more often in Caucasians than in people of Asian or African descent. There are several underlying causes that can lead to syndactyly. Down syndrome is one of the most common causes. Rarer causes include Apert syndrome, Carpenter syndrome, Cornelia de Lange syndrome, Pfeiffer syndrome, and Smith-Lemli-Opitz syndrome. In all of these cases, syndactyly is just one of a group of interconnected symptoms.
Syndactyly itself is often inherited, in which case it is referred to as hereditary syndactyly. The condition can also occur in combination with having one or more extra fingers or toes, a condition called polydactyly. When the two conditions are combined, it is called polysyndactyly. Hereditary syndactyly is found in Angus cattle, as well as humans. While polydactyly is frequently found in cats, polysyndactyly is specific to humans.
Syndactyly can be more or less serious and the precise situation dictates the treatment. It occurs most frequently between the third and fourth toes. In incomplete syndactyly, the fingers are only partially joined, while in complete syndactyly, the fingers are joined to the tip. Simple syndactyly refers to texture that is just skin and soft tissue, while complex syndactyly refers to a joint that includes connected bones. In complicated syndactyly, extra bone and abnormal development of ligaments and/or tendons are also involved.
Only in half of the cases does syndactyly occur bilaterally; the other half of the time it’s only on one hand or one foot or the other, not both. Corrective surgery is usually performed when the child is five to six months old or between one and two years old, according to two different sources. Early intervention is desirable in more difficult cases and when the situation is not treated it would lead to further problems.
In simple cases, the webbing between the toes is severed and skin grafts taken from the abdomen are used to minimize scarring. A cast is used after surgery to both immobilize the hand and protect the skin graft. After about three weeks, the cast is removed and splints are used for the next six weeks to keep the involved toes apart. Occupational therapy helps the child improve the use of the hand.
In cases where syndactyly is isolated, the prognosis is excellent. In cases where it is part of a syndrome, the results will depend on the general condition of the child. For example, in some cases, syndactyly is associated with heart problems. In such cases, the heart condition may determine when and if the child needs to be operated on.
