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At Boston Children's Hospital, experts in our Orthopedic Center's Hand and Orthopedic Upper Extremity Program and our Plastic Surgery Department's Hand and Microsurgery Reconstructive Program provide comprehensive care for syndactyly—including evaluation, diagnosis, consultation, surgery and follow-up care.
Our orthopedic surgeons and plastic surgeons usually treat children with syndactyly by surgically releasing the fingers from their webbing. This procedure is typically performed when the child is between 1 and 2 years old. At this age, the child is old enough to tolerate anesthesia and surgery but is not at risk for missing developmental milestones such as grasping (prehension).
• In general, the skin is split evenly between the two fingers with zig-zag incisions (z-plasty).
• Only one side of a finger is separated at a time in order to avoid complications related to the skin coverage and
blood supply of the affected finger. For this reason, if your child has multiple fingers that are joined, more than
one surgical procedure will be needed.
Complications right after surgery for syndactyly are uncommon and usually minor. But medium- to longer-term complications can include:
• recurrence of the condition (web creep)
• inadequate blood supply to the finger (finger ischemia)
• shortening and hardening of scar tissue (scar contracture)
• skin graft complications
• nail plate deformity
After surgery, your child is usually placed in an above-elbow cast for three weeks to help immobilize and protect the hand. Once the cast is removed, a splint that slides in between the fingers and keeps them apart is used for an additional six weeks. During this time, your child's doctor may recommend occupational or physical therapy to help reduce scarring, stiffness and swelling and improve function.
We will want to see your child for follow-up visits to ensure that healing has gone well and function has returned. In some cases, follow-up will continue for years to evaluate whether additional surgery is needed to improve the function or appearance of your child's hand.
The good news is that after surgery, most of our young patients have adequate finger function and an improved appearance of their fingers and hands.
Most of our young patients recover full hand function and an improved appearance of their hand. If needed, your child's team will work with you and your child to learn home exercises that are important to his recovery. He may need to wear a cast or splint in some circumstances. If your child's case is severe, he may need additional reconstructive surgery(ies) to recover full function and improve the hand's appearance.
Your child may need to be followed for a number of months or years to:
• ensure that the healing has gone well
• check that function has returned to your child's hand
• determine whether additional surgery is needed to improve the function or appearance of the hand as your
At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit the Hale Family Center for Families for all you need to know about:
• getting to Boston Children's
• navigating the hospital experience
• resources that are available for your family
In particular, we understand that you may have a lot of questions when your child is diagnosed with syndactyly. Will this affect my child long term? Will he be able to play sports and do regular activities? Children's can connect you with extensive resources to help you and your family through this stressful time, including:
• patient education: From doctor's appointments to physical therapy and recovery, our nurses and physical
therapists will be on hand to walk you through your child's treatment and help answer any questions you may
have—Why will my child need surgery? How long will his recovery take? How should we manage home exercises
and physical therapy? We'll help you coordinate and continue the care and support your child received while at
• parent-to-parent: Want to talk with someone whose child has been treated for syndactyly? We can often put you in
touch with other families who've been through the same process that you and your child are facing, and who will
share their experiences.
• faith-based support: If you're in need of spiritual support, we'll connect you with the Children's chaplaincy. Our
program includes nearly a dozen clergy— representing Protestant, Jewish, Muslim, Roman Catholic and other faith
traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital
• social work: Our social workers and mental health clinicians have helped many families in your situation. We can
offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping
with illness and dealing with financial difficulties.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”