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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Complications of the surgical correction of congenital syndactyly include:

  • immediate or early:
    • division of nerve or tendon eg if fused
    • ischaemic digit eg digital artery damaged or digit swells with a tight graft
    • haematoma
    • infection
    • graft loss due to shear, infection or haematoma
  • late:
    • deformity of digits or the web:
      • contracture may occur in up to 50% of cases
      • commonly either flexion or lateral deviation
      • more rarely, rotation
      • either due to scarring on the ipsilateral side to the deformity or a growth disturbance secondary to surgery
      • particularly common with contracture secondary to split thickness skin grafts as opposed to full thickness skin grafts
    • unaesthetic appearance:
      • hair growth on graft in around 10% of all cases
      • nail growth abnormality
      • abnormal pigmentation of, for example, groin skin graft relative to surrounding skin; occurs in approximately 5% of all cases
    • "web creep":
      • advancement of the new web space margin distally down the digits with time
      • around 20% of cases develop
      • may be due to scar contracture or relative growth of soft tissue within the web

Deformity and web creep are the main reasons for re-operation which may be necessary in up to 50% of cases.

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