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Management

Authoring team

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

Reference

  1. Dao KD et al. Surgical treatment of congenital syndactyly of the hand. J Am Acad Orthop Surg. 2004 Jan-Feb;12(1):39-48

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