According to the Robert Debré University Hospital, the prevalence of this malformation is 1 case per 2,000 to 2,500 births. We distinguish simple syndactyly, which concerns the fusion of the skin only, from complex syndactyly, relating to a fusion of bones and skin. This malformation can be unilateral or bilateral, occurring along the entire length of the fingers or toes, or simply at their base. Surgical intervention between the child’s 10 months and 3 years is generally considered. Find out what congenital syndactyly is and how it is treated.
1. Definition of congenital syndactyly
Congenital syndactyly is a birth defect that affects your baby’s fingers or toes. It results in webbing or fusion of the fingers or toes. This malformation can be simple or complex. In simple cutaneous syndactyly, only the skin has fused. In the case of complex syndactyly, also called osseous syndactyly, the skin and bones have fused. It is the 3rd and 4th fingers which are mainly affected by this malformation (57% of cases), specifies the Robert Debré university hospital. This fusion of fingers or toes can occur along the entire length of the fingers (complete syndactyly), or only at their base (incomplete syndactyly). And depending on the case, it is accompanied by a fusion of the nails or not. Finally, this congenital malformation is bilateral in 1 in 2 cases.
2. Causes of congenital syndactyly
Syndactyly is a birth defect that occurs between the 6th and 8th weeks of pregnancy, when the fingers and toes are supposed to separate. The causes of this pathology have not all been identified. A hereditary factor is observed in 10 to 40% of cases, specifies the MSD Manual. Genetic transmission occurs in the autosomal dominant mode, that is to say, an anomaly in a single copy of the gene, in the father or mother, is enough for the malformation to be transmitted. Other genetic diseases and syndromes can also manifest as syndactyly, indicates the Lenval Foundation, namely Apert, Poland, or Carpenter syndrome.
3. Treatments for this malformation of the fingers or toes
Surgical procedures to defuse your child’s fingers or toes usually take place before he or she is 3 years old. If the syndactyly is isolated, intervention is generally decided around the age of 18 months. If more than 3 fingers or toes are affected, then several interventions are necessary. When there is a skin fusion alone (simple congenital syndactyly), the surgical intervention under general anesthesia consists of separating the fingers while preserving their nerves and vessels. Then a dressing and healing for 2 to 3 weeks are necessary. In cases of bony syndactyly, the bones must be separated in addition to the skin. In both cases, a skin graft may be necessary to prevent the skin from shrinking at the corner as your child grows.
Sources
- Congenital syndactyly, Robert Debré University Hospital, December 2021
- Finger and Toe Malformations, MSD Manual – Consumer Version, September 2022
- Congenital Limb Malformations, The MSD Manual – Healthcare Professional Version, September 2022
- Syndactyly, Fondation Lenval
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