Surgical treatment of congenital syndactyly of the hand

Syndactyly is a congenital anomaly of the hand that is more common in males, is present bilaterally in 50%, of affected patients, and often is associated with other msculoskeletal malformations or systemic syndromes. The goal of syndactyly release is to create a functional hand with the fewest surgical procedures while minimizing complications. For simple syndactyly, surgical reconstruction can begin at approximately 6 months, although many surgeons prefer to wait until the infant is 18 itioriths old. Special situations, such as complcx syndactyly and involvement Of border digits, may zoarrant surgical intervention earlier than 6 months. Reconstruction of the zuch commissure is the most technically challenging part of the operation,followed by separatim of the remaining digits. Full-thickness skin grafting is almost always required for soft-tissue coverage. Complex syndactyly and syndactyly associated with other hand anomalies zoarrant special consideration. After reconstruction, patients should be examined periodically until they have achieved skeletal maturity because late complications such as web creep can occur.