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

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

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