Syndactyly release is a common procedure to undertake for cleft hand deformity. Typically, there is a fusion between the thumb and index finger resulting in deviation of the index finger with time. Increasing defomation interferes with the development of grip function.
Given the absence of the first web space, it is advantageous to import skin at the same time as syndactyly release. This is achieved through a Snow-Littler procedure - see section on cleft closure - or by transposition of the index finger. Frequently, the thumb lies in the same plane as the remaining digits and needs to be rotated out to provide adequate prehension. This can be achieved through rotational osteotomies and soft tissue releases.
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