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Syndactyly

Case contributed by Roberto Rafael Ovalle
Diagnosis certain

Presentation

Presented with fusion of 4th and 5th fingers in both hands

Patient Data

Age: 2 years
Gender: Male
x-ray

Simple syndactyly is confirmed on the right hand and complex syndactyly on the left hand, affecting de 4th and 5th fingers. There is associated absence of the intermediate phalanges in the 5th finger of both hands.

Case Discussion

Syndactyly refers to a congenital fusion of two or more digits and is caused by failure of differentiation of the tissues between the fingers at 5th-8th week of intrauterine life.

This could be classified as simple (only the skin and soft tissue) or complex (bony involvement,  frequently there is also neurovascular involvement).

Traditionally, surgery was postponed until age 3-4 years but currently many surgeons do release at age 9 months to 1 year. Argument for delaying surgery is to avoid postoperative scarring, which may be more common in infants.

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