Syndactyly

What is syndactyly?

If your child has syndactyly, it means that the fingers or toes are webbed or joined and that the condition was present at birth. Syndactyly is a fairly common congenital defect that often runs in families, affecting about 1 out of every 2,500 babies. Caucasians are more likely than African-Americans or Asians and to have syndactyly, and boys are more likely to have it than girls.

Syndactyly affects both hands (bilateral) about 50 percent of the time and most often occurs between the middle and ring fingers. It also can affect a child’s toes as well as fingers; however, the condition poses more complex challenges for hand-and-finger use than for foot-and-toe use.

 

What are the different forms of syndactyly?

Comparison of Incomplete Syndactyly and Complete Syndactyly.

The classifications of syndactyly correspond to the condition’s different types and degrees of complexity. Syndactyly can be classified in the following ways:

  • incomplete: the webbing or joining doesn’t extend all the way to the fingertips
  • complete: the webbing or joining extends all the way to the fingertips
  • simple: the fingers are joined only by soft tissue
  • complex: the fingers are joined by bone or bony cartilage, as well as soft tissue, in a side-by-side fashion
  • complicated: the fingers are joined by bone or bony cartilage, as well as soft tissue, in a fashion other than side-by-side — such as with abnormally shaped, extra or missing bones

What are the causes of syndactyly?

During normal embryonic development (while the baby is still in the womb), the hand initially forms in the shape of a paddle; then — at about the sixth or seventh week of gestation — splits into separate fingers. Syndactyly results if there’s an irregularity in this process: The fingers fail to divide normally (failure of differentiation) and the result is a webbed hand.

Some cases of syndactyly occur in isolation and sporadically — meaning by themselves, for no identifiable genetic reason. In about 10 to 40 percent of cases, the condition occurs as an inherited trait. And in some cases, syndactyly is an accompanying defect in a genetic syndrome, such as Poland syndrome, Apert syndrome, or Holt-Oram syndrome.

Syndactyly is visible at birth. It may also be visible in utero by fetal ultrasound.

How Boston Children's cares for syndactyly

Combining training in pediatric and adolescent orthopedics, hand surgery, plastic surgery, and microsurgery allows our surgeons to provide a comprehensive level of care unmatched in most other hospital settings.

Hand and Orthopedic Upper Extremity Program

The Hand and Orthopedic Upper Extremity Program provides comprehensive care involving occupational and physical therapy, splinting, casting, and reconstructive surgeries for infants, children, and adolescents with complex congenital, neuromuscular, sports-related oncologic, and traumatic upper limb conditions.

You can have peace of mind knowing that the skilled experts in our Hand and Orthopedic Upper Extremity Program have treated thousands of babies and children with many bone-related conditions. We provide expert diagnosis, treatment, and care, and we benefit from our advanced clinical and scientific research.

Hand and Reconstructive Microsurgery Program

The specialists in the Hand and Reconstructive Microsurgery Program at Boston Children's are experts in the management of congenital and acquired hand deformities. We recognize the social elements involved in pediatric hand surgery, so an essential part of these operations has been making the child's hand as symmetrical as possible with the unaffected hand.