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Syndactyly: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Syndactyly is a congenital malformation of the hand, consisting of the fusion of two or more fingers with a violation of the cosmetic and functional state. This anomaly is sometimes observed in isolation, in which case the malformation can be considered a diagnosis. In these cases, the fingers are fully developed, but there is a soft tissue or bone fusion between them. In most cases, syndactyly is a symptom accompanying the main diagnosis (congenital ectrosyndactyly, symbrachydactyly, clefting, radial and ulnar clubhand, brachioradialis synostosis, etc.).
ICD-10 code
Q70 Syndactyly.
Epidemiology
According to a number of authors, syndactyly, either alone or in combination with other deformities, accounts for more than 50% of all congenital hand anomalies. Syndactyly is registered in 1 child out of 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:
- extent of fusion;
- type of fusion:
- condition of the affected fingers.
Depending on the extent and the number of affected phalanges, syndactyly is divided into incomplete and complete. According to the type of fusion, soft tissue and bone syndactyly are distinguished. Depending on the condition of the affected fingers, syndactyly is divided into simple and complex. Simple forms of syndactyly of the hand include fusions of correctly developed fingers without any accompanying deformations. Complex congenital syndactyly of the hand refers to a pathology in which finger fusions are accompanied by concrescences of the phalanges (over a greater or lesser extent), flexion contractures, clinodactyly, torsion or malformations of the bone-articular and tendon-ligament apparatus. According to the localization of fusion, complex syndactyly of the I-II fingers, complex syndactyly of the three-phalangeal fingers, and complex total syndactyly of the IV fingers are distinguished.
Treatment of syndactyly
The condition of the fused fingers determines the age indications and the nature of the intervention.
In simple forms of congenital syndactyly, the operation can be performed before the age of 1 year. During the operation, the fingers are separated using the Cronin or Bauer method, the interdigital folds and partially the lateral surfaces of the fingers are covered with cut flaps. The remaining wound defects on the lateral surfaces of the fingers are replaced with thick split grafts from the thigh and forearm.
In complex forms of congenital syndactyly, treatment is recommended to begin at 10-12 months to prevent the progression of existing deformations and the development of secondary ones. The main principles of surgical treatment of complex forms of congenital syndactyly are considered to be one-stage correction of all components of the deformation while eliminating the fusion and full replacement of wound surfaces on the separated fingers.
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