What is syndactyly?

It’s a condition where two or more fingers are fused together.  Syndactyly is a normal phenomenon on mammals, like the kangaroo, but unusual in humans.

Syndactyly can be simple or complex.  The simple case is characterized by adjacent fingers or toes that are joined by soft tissue; the complex case by having fused bones of adjacent digits.  It can also be complete, which means the skin is merged all the way to the fingertip; incomplete or not fully joined.

Complex syndactyly takes place due to a syndrome and often involves more digits.  Simple syndactyly occurs in fetal development stages, in which during this time syndactyly is normal, but is retained even after birth due to failure of a process that breaks the webbing of the fingers from taking place on some parts.

Syndactyly is treated when border digits, such as thumb/index finger or ring/pinky finger, are joined in early life to prevent the larger digit to curve towards the smaller digit with growth.  The infant is usually at an age of 6 months when treatment is conducted.  This correction is optional and commonly performed when the digits have grown enough — frequently at 18 to 24 months.

Since the skin surrounding conjoined fingers is less than that found in separate fingers, there is not enough to cover both digits once they are separated.  The workaround for this is either through skin grafting or by mobilizing the skin from the back of the hand.

The most common issue with a syndactyly operation is the creeping of the skin to the fingertip as time goes.  The cause is likely tension at the area where repair has been made.  There are also problems associated with using skin grafts, where they may darken and become more noticeable through the years.  The graft may also grow hair if skin was taken from the groin area.  Lastly, fingers may deviate — common in cases of complex syndactyly.

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