management

Last reviewed 01/2018

Ideally, the management of syndactyly should be undertaken by a surgeon with a specialist interest in paediatric hand surgery. General principles include:

• releasing border digits first if multiple digits are involved
• avoiding:
  • single-stage releases on both sides of a digit at the same time to limit the risk of finger devascularisation
  • straight line incisions on the volar surface of digits to limit the tendency to scar contraction
  • skin grafting in the commissure
• for aesthetic reasons:
  • scars should be avoided on the dorsum of the hand
  • the new web should slope at about 45 degrees from dorsal to volar
  • the volar distal border should have a gentle U-shaped curve