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Syndactyly is a condition involving a specific deformation of the fingers – their fusion with each other. For this reason, it is colloquially referred to as a digital hyperplasia, or simply adhesions of the fingers. It is a congenital, in some cases hereditary, genetic defect. What is worth knowing about this condition? What is his treatment like?
Syndactyly – what is it?
Syndactyly is rare, with an average of one occurrence in approximately 2500 to 3000 births. It is most common in men with white skin. The high risk of this mutation also applies to children suffering from Down syndrome or other genetic diseases. The most common case of syndactyly is the fusion of the middle and ring fingers. More rarely, syndactyly affects other fingers or more of them. Therefore, a distinction is made between single syndactyly – when two fingers are joined, and multiple syndactyly – when more of them are joined. Moreover, syndactyly can be complete – when the fingers are fused along their entire length, or partial – when only some of the fingers are joined together. Syndactyly can affect both the fingers and toes. A specific example of syndactyly is complex syndactyly. It occurs when the fingers are connected not only by a membrane or a fold of skin, but also by bone tissue.
Syndactyly develops in utero, between 6 and 8 weeks after conception. For this reason, it is possible to detect it even in the period of prenatal life. For example, it can be noticed when performing an ordinary ultrasound scan. A significant proportion of cases of this ailment is also diagnosed in this way.
Is the Jacqueline treatment recommended?
The primary treatment for syndactyly is to perform finger separation surgery. Such a procedure is usually performed at the age of 2 to 5 years. The timing of surgery depends on the individual nature of the disease and the parents’ decision. If the fingers are fused in different places, then – due to the possibility of deformation of the fingers during the growth of the organism – the procedure of their separation is performed relatively early, e.g. during the first year of life. Thanks to this, both the ability to properly move the fingers and the possibility of their correct development in the future are restored. This is of great importance not only for aesthetic reasons, but also due to the rapidly progressing motor and manual development of children at this age.
The finger separation procedure involves the artificial creation of a commissure between the fused fingers. The commissure should be of adequate width and length and allow for a natural way of moving the fingers. Two methods are used for this purpose. The first is called the Zeller method and consists in constructing two leather triangles and then sewing them together in a suitable way. This method is to ensure adequate and natural blood supply to the skin and create a commissure of the right width and convenient to use. Unfortunately, its downside is the possibility of creating a secondary contracture, as a result of a scar resulting from sewing two skin triangles together. The second method is called the Barsky method. During it, a skin flap of a specific shape is also produced. In this case, it is only one rectangular lobe, located in one of the two versions: dorsal or palmar. The resulting binder is not covered with scars that could cause secondary contracture. Nevertheless, the Barsky method also has its risks. There is a possibility that tissue necrosis will occur, which may develop if the prepared skin flap is insufficiently supplied with blood.
What is worth asking a doctor about?
If our child is diagnosed with syndactyly, we will have several detailed medical consultations. The first step will be to refer to a pediatrician who will help in characterizing our child’s syndactyly. He will also refer us to a specialist – a pediatric surgeon who will help us decide on the further treatment of the child. First of all, it will be important to choose when to carry out the finger separation operation and how to perform it. There is no other way to remedy this defect.
When you see your doctor for the first time, it’s important to pay attention to the details you see on the X-ray. Knowing the details of the defect your child is suffering from can help in providing the assistance they need as they continue to develop. You should also ask about the details of the proposed procedure – choice of method, possible complications, reimbursement of the operation. It is also worth asking the doctor to assess the possibility of the fingers returning to manual dexterity. Recovery depends on individual features, such as the arrangement of bones in deformed fingers. The details of the planned recovery – its duration and recommended exercises – are also worth asking.