Clinical features

Clinical features of congenital syndactyly usually are noted at birth with fusion of the digits of hands, feet or both. Mild webbing may not be appreciated immediately and can present late. There may be fusion of skin, bone and/or nails. The middle-ring finger web is most commonly affected in the hand whereas the second web is usually affected in the foot. There may be associated joint stiffness.

When evaluating syndactyly, it is important to note the distal extent of the interdigital connection and which digits are affected to determine whether the fusion involves only soft tissue or a combination of soft tissue and bone.

As well as an obvious cosmetic deformity, syndactyly presents an overriding functional problem. Normal grasp is difficult to develop when conjoined digits are restricted in motion and in which the pulp may not have a normal nail. Late-presenting syndactyly children may exhibit the development of abnormal grasp patterns.

Reference

1. Buck-Gramcko D. Congenital malformations of the hand and forearm. Chir Main. 2002 Mar;21(2):70-101