Syndactyly
Syndactyly
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What are different types of syndactyly?
- Incomplete: Just part of fingers is involved.
- Complete: Involves complete fingers all the way to the tips.
- Simple/Cutaneous: Only skin connection between the fingers
- Complex: Includes bony interconnections between the fingers.
- Complicated: usually associated with the syndrome.
- Acro syndactyly: Fingers are fused towards the tip and they are free at the web space.
- Symbrachydactyly: Fingers are short and webbed
Why to consult a Plastic surgeon?
Separating fingers is not as simple as cutting the skin and connecting the fingers because there is not enough skin. Syndactyly must be corrected through series of carefully designed flaps. Some require skin graft. Kids are placed in bulky soft dressing until 2 weeks after surgery and then they start physiotherapy. Physiotherapy is as important as surgery to keep the scar soft and maintain range of motion.
When to perform surgery for syndactyly?
FAQ's
Most of the surgeries are uneventful and child behaves well with good function and satisfactory appearance after surgery. However, infection, web creeping, non-survival of skin grafts and flaps are some of the possible risks. Some children may need second surgery.
It is scarring in the commissure between the fingers that leads to partial recurrence of syndactyly.
Usually only one surgery is needed that affects only two fingers. Some patients may need second surgery most commonly to deal with web creeping.
The skin surrounding two joint fingers is not enough to cover the fingers when they are separate. A straight-line incision tends to scar in a band which contracts over a period of time. Skin at the base of the finger(commissure) is most likely to scar and must be reconstructed most carefully to look near normal.
Most of the raw area created after separation of fingers is covered by the local flaps. Some area if at all needed is covered with full thickness skin graft. Donor sites for skin graft are Groin, front of wrist and elbow.