Syndactyly: causes, symptoms, diagnosis, treatment

Syndactyly - congenital malformation of the hand, consisting in the union of two or more fingers with a violation of the cosmetic and functional state. This anomaly is sometimes observed in an isolated form, in which case the developmental disorder can be considered a diagnosis. In these cases, the fingers are developed fully, but between them there is soft-tissue or bone fusion. In the majority of cases, syndactyly is a symptom that accompanies the main diagnosis (congenital ectrosindacty, symbrachidactyly, splitting, radial and ulnar steelyardism, brachial synostosis, etc.).

ICD-10 code

Q70 Syndactyly.

Epidemiology

The share of syndactyly in isolated form or in combination with other deformations, according to a number of authors, accounts for more than 50% of all congenital anomalies of the hand. Syndactyly is registered in 1 child from 2000-4000 children. Up to 60% of children with syndactyly have concomitant congenital pathology of the musculoskeletal system.

Classification of syndactyly

Congenital syndactyly of the hand is characterized by a variety of clinical manifestations.

The classification of this defect is based on:

• length of adhesion;
• type of adhesion:
• condition of the affected fingers.

In length, depending on the number of captured phalanges, the incomplete and full form of syndactyly is distinguished. According to the type of fusion, soft tissue and bone syndactylium are distinguished. Depending on the condition of the affected fingers, simple and complex syndactyly is isolated. To simple forms of syndactyly, brushes include fusions of properly developed fingers without any accompanying deformations. Under the complex form of congenital syndactyly, brushes are understood as a pathology in which fusions of the fingers are accompanied by concreteness of phalanges (on a greater or lesser extent), flexural contractures, clinodactyly, torsion or malformation of the osteoarticular and tendon-ligament apparatus. On the localization of fusion, the complex syndactyly of the I-II fingers, the complex syndactyly of the three-phalanx fingers, the complex total syndactyly of the fourth finger are isolated.

Treatment of Syndactyly

The condition of the fused fingers determines the age indications and the nature of the intervention.

With simple forms of congenital syndactyly, the operation can be performed before the age of 1 year. During the procedure, the fingers are divided according to the Cronin or Bauer method, the interdigital folds and partially the lateral surfaces of the fingers are closed with the cut out flaps. The remaining wound defects on the lateral surfaces of the fingers are replaced by thick, split grafts from the hip and forearm.

With complex forms of congenital syndactyly, treatment is recommended to begin at 10-12 months to prevent the progression of already existing strains and the development of secondary ones. The main principles of surgical treatment of complex forms of congenital syndactyly are the one-stage correction of all components of deformation when the adhesion is eliminated and the full replacement of the wound surfaces on the divided fingers.