Syndactyly, or webbing of fingers or toes, is the most common congenital malformation of the limbs, with an incidence of 1 in 2000-3000 live births. Syndactyly can be classified as “simple” when it involves soft tissues only or “complex” when it involves bones, tendons, or nails beds. It is a shared feature of more than 28 syndromes, including Poland, Apert, and Holt-Oram syndromes. Syndactyly is the result of a failure of fingers or toes to separate during embryological development into individual digits. This separation usually occurs during the sixth to eighth weeks of gestation. The root words of the term syndactyly are derived from the Greek words syn-, meaning together, and -dactyly, meaning fingers or digits.
Surgery is the only solution available currently to separate fused fingers or toes. Adjacent skin flaps in conjunction with skin grafts are used to resurface the areas between the digits. When bone or tendons are involved, the surgical approach is slightly more complex and requires splitting of the involved structures. In the setting of multiple syndactylies, a staged approach is necessary to separate fingers or toes in order to avoid damage to vital blood vessels and nerves. Correction of syndactyly may begin as early as 3 months of age. This is often an outpatient procedure.
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