Conditions + Treatments

Treatments for Syndactyly in Children

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Contact the Hand and Orthopedic Upper Extremity Program

  • 617-355-6021
  • International: +1-617-355-5209
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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.

How is syndactyly treated?

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).

What happens during surgery?

   •   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 after surgery

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

Caring for your child after surgery

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.

What is the follow-up treatment plan?

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.

Long-term outlook

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
       child grows

Coping and support

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
   •   accommodations
   •   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.

Boston Children’s is so much more than a hospital—it’s a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible. ”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000
For Referring Providers: 844-BCH-PEDS | 844-224-7337