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L. Indumathi*

Nurse Educator, Department of Nursing, Kauvery Hospital, Salem

*Correspondence: indumaya1986@gmail.com

What is your diagnosis?

Answer: Syndactyly (webbed digits)

Syndactyly is a condition in which children are born with fused or webbed fingers. About half of children with syndactyly have it in both hands (bilateral). Most of the time, syndactyly affects the fingers. Sometimes it affects the toes, but not as often.

While any two or more fingers can be joined, syndactyly most often occurs between the middle and ring fingers. The fingers may be connected by a flap of skin that looks like webbing. In other cases, the fused digits may look almost like a single finger.

Syndactyly is fairly common. It affects about 1 out of every 2,500 babies. The condition tends to affect boys more often than girls and white children more often than Black or Asian babies.

About 10 to 40 percent of children with syndactyly inherit the condition from a parent. In some cases, the condition is part of genetic syndrome, such as Poland syndrome or Apert syndrome.

The child may require a surgery, during surgery, the skin is split evenly between the two fingers. That may need a skin graft or a skin substitute to cover the newly separated fingers. Skin grafts are usually taken from the elbow or wrist crease to minimize scarring.

To avoid possible complications, only one side of a web space is separated at a time. If your child has several fingers involved, they will need more than one surgery.

The child will wear a cast or bandage covering their hand, lower arm, and elbow for two to three weeks. This will keep their hand still and protect the healing skin. Once the cast comes off, they will wear a splint to keep the fingers apart for six weeks.

The doctor may recommend occupational therapy to reduce scarring, manage stiffness and swelling, and improve function.

Some children who have had surgery experience web creep as they grow. This happens when scar tissue grows in the space between the fingers, making it look like syndactyly is coming back. Your child may need a second surgery if this happens. Web creep is more common when the digits are separated before age 1.

Your child should have regular follow-up visits with their care team to make sure their hand is healing and moving well. They may need to be seen for several years. Some children need another surgery to improve the function and appearance of their hand.

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What is your diagnosis?

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