Patient′s current hand function

• 
  

  Symmetric/asymmetric use of hands.

  
  
• 
  

  Grasping style.

Known medical comorbidities.

Family history of syndactyly or other associated condition (autosomal dominant or sporadic).

Difficulties during pregnancy.

Perform full body examination.

• 
  

  Other congenital anomalies may have not yet been diagnosed. Consider syndromic etiology if appropriate.

  
  
• 
  

  Evaluate feet to rule out additional digits with syndactyly.

Perform complete hand evaluation.

• 
  

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

  
  
  
  
  • 
    

    Assess for polydactyly.

    
    
  • 
    

    Evaluate for digital deviation in the radial or ulnar plane (clinodactyly).

  
  
• 
  

  Examine contralateral hand for comparison.

  
  
• 
  

  Thoroughly evaluate entire upper extremity.

Classification

• 
  

  Simple/complex

  
  
  
  
  • 
    

    Simple syndactyly: Finger fusion only by a skin bridge.

    
    
  • 
    

    Complex syndactyly: Finger fusion involving bone connection.

  
  
• 
  

  Complete/incomplete

  
  
  
  
  • 
    

    Complete syndactyly: Fusion involves entire length of the finger to distal tip, including nail fold.

    
    
  • 
    

    Incomplete syndactyly: Fusion does not involve nail fold, but web depth is distal to normal position.

  
  
• 
  

  Complicated: Includes polydactyly.