Finger Deformity (Syndactyly) Correction
Frequently Asked Questions (FAQs)
- Thumb-index finger syndactyly or ring-small finger syndactyly should be corrected early between 3 and 6 months.
- Index-long finger and long-ring finger syndactyly can be reconstructed between 12 and 18 months.
- The skin surrounding 2 joined fingers is not enough to cover the fingers when they are separate. A straight line incision tends to scar in a band that tightens (contracts) over time.
- The skin at the base of the fingers (the commissure) is most likely to scar and must be reconstructed most carefully to look near normal and to prevent recurrent scarring or web creep.
Full-thickness skin grafts are needed to fill the spaces not covered by native finger skin. The graft can be taken from different areas including the groin and the front of the elbow.
A bulky soft dressing is placed on the hand and over the elbow). Dressing change is done after 2 weeks to allow for the healing of skin grafts and stitches.
Physiotherapy is initiated after that so as to allow the child to relearn and adjust to the new condition.
- Most surgeries are uneventful and the child does well with a satisfactory appearance after surgery and excellent function.
- Infection is a risk with any surgery. Sometimes a low-grade infection can threaten skin grafts.
- Skin grafts and flaps may not survive after surgery. This complication is very rare.
- Web creep is perhaps the most notable risk. Web creep is scarring in the commissure between the fingers that lead to a partial "recurrence" of syndactyly.
- About 1 out of 3 children will need a second surgery. For some types of syndactyly, that number is higher.
Usually, only one surgery is required for syndactyly that affects only 2 fingers. However, about 1 out of every 3 patients will need another surgery - most commonly to deal with web creep.
Complex syndactyly is most commonly a bony connection between the fingers near the fingernails. The reconstruction process is similar to cutaneous (or "simple") syndactyly but the fingers typically have a less satisfactory outcome. Even with appropriate surgery, the fingernails are often deformed and the fingers may be angled or rotated. Additional surgeries to straighten the fingers may be helpful in these children.