Syndactyly

Syndactyly represents the failure of the fingers to separate while the child is developing in utero. Syndactyly can be either simple in which there is only skin attachment between the respective fingers and/or complex in which there is both skin and bony involvement. In either event, surgical intervention is the only way to separate the fingers. If the finger is a border digit, i.e., the small and/or index finger, then surgical intervention is done in a more urgent fashion, i.e., after one year of age. Typically, elective pediatric surgery is done after one year of age because it is necessary to wait for the development of the heart and lungs in a young child. In addition, development of the liver and metabolism of anesthetic agents is better performed after one year of age. Division of the fingers in a patient with syndactyly is done under general anesthetic and involves the use of skin graft harvested from the patient. If there are multiple fingers involved and/or continuous fingers, only one side of the finger is done at an operative setting. This is to prevent compromise of the vascular circulation to the fingers.