Case 59 Syndactyly

Angie M. Paik and Reena A. Bhatt

Case 59 Syndactyly

Case 59 (a, b) A 1-year-old male presents to the clinic with fusion of the left ring and small fingers.

59.1 Description

  • Simple, complete syndactyly involving the ring and small fingers of the left hand

59.2 Work-Up

59.2.1 History

  • Gestational history and issues during pregnancy

  • Medical comorbidities and any previous medical work-up

  • Family history of syndactyly (autosomal dominant with variable expressivity and incomplete penetrance) or associated syndromes (e.g., Poland or Apert syndromes)

  • Patient’s current handedness and hand function

59.2.2 Physical Examination

  • Perform total body examination

    • Evaluate for any craniofacial or chest wall anomalies

    • Examine feet and contralateral upper extremity to rule out additional syndactylies

  • Complete upper extremity examination

    • Assess for extent and location of webbing as well as the number of digits involved

    • Look for other concurrent deformities (i.e., polydactyly, clinodactyly, brachydactyly, and symphalangism)

    • Examine contralateral hand for comparison

    • In children, assess for hand function by evaluating the patient during play

  • Classification

    • Simple/Complex

      • Simple syndactyly: No bony fusion

      • Complex syndactyly: Bony fusion

    • Complete/Incomplete

      • Complete syndactyly: Fused web space extends to fingertips

      • Incomplete syndactyly: Web space involvement but fingertip and nail are spared

    • Complicated: Associated with a syndrome

59.2.3 Pertinent Imaging or Diagnostic Studies

  • Hand three-view X-rays: Image bilateral hands to assess for underlying bony fusion and additional anomalies

59.3 Consultations

  • Occupational therapy

  • If indicated: Genetics and cardiology

Only gold members can continue reading. Log In or Register to continue

Jul 17, 2021 | Posted by in General Surgery | Comments Off on Case 59 Syndactyly
Premium Wordpress Themes by UFO Themes