Syndactyly

Syndactyly is one of the most common congenital anomalies in upper extremity. It can be an isolated condition or may be a part of a syndrome. Most syndactyly types are autosomal dominant which is frequently associated with less severe phenotypes because of its variable expressivity and incomplete penetrance. Clinical examination includes a first perspective of deformity to recognize the digits affected and also an observation of both hands and feet to look for associations. Syndactyly could be simple, with cutaneous compromise or complex with bony fusion association. Also incomplete, when the web space occurs anywhere between the commissure and the fingertip; or complete when the web space includes the fingertip. Complicated syndactyly occurs when there are polydactyly association, severe coalition, or finger interposition. When surgery is indicated, the age of the patient at the time of the procedure and the type of deformity are important factors to consider. There are many techniques of surgical release, with or without skin graft, and the main objective is to achieve appropriate function of the hand. Preoperative planning should be done, paying attention on commissure reconstruction, digit separation, and flap closure.