.png)
Syndactyly is a condition of the hands and feet where two or more digits are fused together. It is a congenital abnormality, and is the most common abnormality of the limbs, with an incidence of about 1 in 2,000-3,000 live births.
During normal fetal development, the spaces between the developing fingers and toes are webbed. Between the six and eighth months of gestation, an enzyme functions to break down this tissue, giving the developing fetus separate fingers and toes. When this process fails, the result is syndactyly.
Syndactyly is classified based on the extent of the fusion. When it is only soft tissue that connects the two digits, it is called simple syndactyly. When the digits are connected with bone, it is called a complex syndactyly. Syndactyly can also be complete, meaning that the entire digit all the way to the tip is fused, or incomplete when the fusion does not go all the way to the tip of the finger or toe. A fenestrated syndactyly occurs when the fusion goes all the way to the tip of the finger or toe, but there is a gap in between the fused digits with normal skin on either digit. Fenestrated syndactyly is generally associated with amniotic band syndrome.
Syndactyly may be seen as a single abnormality in either the toes, fingers, or both. It is also commonly seen as a part of a syndrome, such as Apert’s syndrome.
Treatment of syndactyly is surgical, and varies widely in its application and timing. Functional limitations are usually addressed right away when they are present at birth, generally before the age of two. The goal of surgery is to restore function to the affected digits, particularly when the syndactyly is in the hand affecting the thumb and pincher grip. Syndactyly of the toes may not be addressed until later in life, particularly when there are significant cosmetic issues and associated psychological issues pertaining to the toes.
The planned surgery is dependent on the digits involved, whether the syndactyly is simple or complex, complete or incomplete, and many other factors. Syndactyly may also be seen in association with polydactyly, which is an increase in the number of digits. In these cases, the extra digits may be removed.
In just about all cases of syndactyly, a graft of skin will have to be used to cover the exposed area once the digits are separated. A skin graft is frequently taken from either the back of the hand or the top of the foot, or sometimes from the groin. In addition to grafting, rotational skin flaps are frequently used to advance skin into the area where it is needed.
No comments:
Post a Comment