Syndactyly

Syndactyly

People with syndactyly have a congenital malformation of their hands and feet. Fingers and toes that have grown together are noticeable. Syndactyly can occur alone or in conjunction with other hereditary diseases.

What is syndactyly?

Syndactyly is a malformation of the hands or feet during the embryonic development phase. The separation of the toes and fingers, which takes place between the 5th and 7th week of development of the embryo, is disturbed. For what is hepatitis d, please visit gradinmath.com.

Syndactyly is one of the most common hand malformations, with simple syndactyly affecting around one in 3,000 newborns. The term comes from the Greek: “syn” means together and “daktylos” means fingers, which consequently have grown together. In extreme cases, this applies to all fingers of one hand. The third interdigital crease is most commonly affected on the hand and the second interdigital crease on the feet.

Individual toe and finger phalanges therefore do not divide completely. Syndactyly is relatively common. The mobility of the fingers is limited due to the disease. If all fingers are affected, the normal gripping function is not possible. This is referred to as the so-called spoon hand. This malformation is often a genetic disease (Apert syndrome).

It is the most common of the hand deformities. Syndactyly is differentiated according to the degree of the affected limbs: cutaneous syndactyly can result in a connection of only the skin between the affected limbs. In bony syndactyly, on the other hand, parts of the bones fuse. Separation is possible in most cases of syndactyly and is performed before the end of the 3rd year of life if possible.

Causes

The cause of syndactyly is genetic. Those affected have a dominant gene that causes this hereditary disease. The frequency of inheritance is between 10 and 40 percent familial.

Due to the defect, the limb sections do not separate in the intended development phase of the embryo. Syndactyly does not only occur as a single disease. In many cases, it is an accompanying symptom of other genetic diseases. What they all have in common is that they influence the normal development of the embryo.

Syndactylies are only developed to a very small extent later in life. In these cases it is exogenous syndactyly. In most cases, they can be traced back to an injury or an accident, as a result of which the healing of the skin or bones was not or could not be properly treated medically.

Symptoms, Ailments & Signs

Syndactyly is primarily noticeable through deformities in the hands and feet. Affected individuals have fused fingers and toes, resulting in difficulty in moving and gripping. Depending on the extent of the disease, even simple movements can no longer be carried out.

In the long term, syndactyly leads to significant limitations in everyday life. In the later course of the disease, bony connections form between the fingers and toes, which can be felt externally and restrict the mobility of the joints. The so-called acrosyndactyly results in fingers or toes of different lengths.

Subsequently, holes form in the skin bridge, which can become inflamed. Syndactyly and acrosyndactyly mainly affect aesthetics, although movement restrictions can also develop as the disease progresses. Especially in the case of a serious illness, there is a risk that serious complications will arise as a result of the fused limbs.

If left untreated, fine motor skills and sense of touch progressively deteriorate. The affected children often also suffer mentally from the aesthetic abnormalities. Social anxiety or even depressive moods can then develop. Early surgery can completely eliminate the symptoms.

Diagnosis & History

Syndactyly can be detected by visual examination after birth. Imaging procedures are then used to determine which form of syndactyly is present. In this way, the connecting bone bridges can be determined more precisely in osseous syndactyly.

In most cases, syndactyly can already be recognized prenatally in the preventive examinations of the pregnant woman. This allows the child’s parents and the treating physicians to adjust to syndactyly at an early stage. In the area of ​​the toes, in most cases it is an aesthetic problem that has no impact on the development of the child.

The course of syndactyly on the finger joints is different. Children need the ability to grasp in order to be able to develop appropriately for their age. Untreated syndactyly on the hands can lead to developmental disorders.

Complications

In syndactyly, the primary complications are the fingers and toes that have grown together. Depending on how severe the malformation is, the affected children will not be able to cope with everyday tasks without outside help. This can mean that those affected develop much more slowly than their peers and only become really independent late in life.

If the child is not helped, this can lead to developmental disorders, since fine motor skills and the sense of touch are not sufficiently encouraged. Those affected often also suffer from the cosmetic abnormalities associated with syndactyly and withdraw from social life at an early age. Teasing and bullying cannot be ruled out either. Surgical treatment of the malformation can always cause complications.

Surgical procedures occasionally lead to nerve injuries, infections and bleeding. Wound healing disorders and postoperative bleeding can occur after an operation. Because of the scarring, the aesthetic impact may be even more noticeable than before. Finally, the prescribed medication also carries a certain risk. In children in particular, an incorrect dosage or an undetected previous illness can quickly lead to unexpected side effects or interactions.

When should you go to the doctor?

Malformations or mutations in the limbs are usually diagnosed immediately during or after birth. In many cases, irregularities in imaging procedures can already be detected in the preliminary examinations during the gestation. For this reason, expectant mothers should take part in all examinations offered during pregnancy. These enable early detection and, if possible, the first treatment steps.

If abnormalities were noticed before the birth, an inpatient birth is often recommended. The team of obstetricians present independently and independently takes over the initial examination of the offspring. In these cases, the parents do not have to become active, but should be accessible to the treating physicians so that the necessary decisions can be made as quickly as possible.

Midwives or helpers are also present in the case of a birth in a birthing center or in the case of a home birth. Just as with a birth in the hospital, they take care of the initial examination of the child. The deformity of the fingers and toes is determined by visual contact. The attending obstetricians then inform a doctor about the health problems.

Here, too, parents do not have to take any further measures, as these are taken over by the medical supervisors themselves. In rather rare cases, there is a spontaneous birth where no nursing staff is present. A doctor should always be consulted immediately after the birth.

Treatment & Therapy

Treatment of syndactyly consists of surgical procedures to separate the fused limbs. This mainly affects the phalanxes, since the separation there goes beyond an aesthetic correction.

The operation takes place very early. If the syndactyly is only cutaneous like webbed skin, an operation is very unproblematic. It is more difficult if the fusion of the bones is so pronounced that two limbs with the same bone structure cannot be determined. During the separation operation, it must also be taken into account that the changes usually also affect the nerves and vessels (arteries and veins).

A careful separation is therefore required. In the case of syndactyly of the toe phalanges, treatment is often dispensed with and the decision is left to the person concerned. Many people with syndactyly of the toe phalanges avoid having it surgically corrected at all. They do not find the limbs that have grown together disturbing.

Depending on the degree of syndactyly, an operation is also not advisable, since the aesthetic impairment caused by scarring can be even more noticeable than the previously existing deformation.

Prevention

Syndactyly cannot be prevented. It is a genetic deformation that is already present in the embryo. Even with a prenatal diagnosis, however, there is no reason for the child’s parents to worry if other diseases have been ruled out. The syndactyly on the feet is a visual impairment that has no consequences for the children. Surgical treatment of syndactyly in the phalanges can also be carried out well in infancy.

Aftercare

Follow-up treatment is important if the fingers or toes that have grown together have been separated from one another by an operation. The dressing technique is in the foreground. If the bandage is too small, there is a risk that a child will unintentionally remove it during the night. Therefore, after syndactyly surgery, the bandages should be large enough, which requires some effort.

If the toes were separated during syndactyly surgery, the patient wears a special shoe for a period of two to three weeks. Aftercare can be taken over by a resident doctor who has already gained sufficient experience with this type of intervention. In most cases, however, the hospital takes care of the follow-up treatment due to the high effort involved in changing the bandages. The bandage is usually worn for around two weeks after syndactyly surgery. Then the threads are pulled.

To treat the pain, the patient is given an analgesic for the first day or two. These are mostly paracetamol suppositories. Special scar gels are administered to counteract the scars that form as a result of the surgical procedure. They help to keep the scars as inconspicuous as possible. After an operation to separate the toes, the use of crutches can be useful, which is ultimately decided by the attending physician.

You can do that yourself

Syndactyly is a congenital disease that can only be treated symptomatically. The affected persons need the support of a specialist doctor and also help in everyday life.

If several fingers have grown together, an operation can be considered. However, the movement restrictions often remain permanent. The most important thing to do is to do regular exercise. If circulatory disorders occur, the doctor must be consulted. If these measures do not bring any improvement, it is best to speak to the doctor again. Sometimes the disorder is so severe that it is no longer possible to improve mobility. Then supportive tools must be used to compensate for the limitations.

Surgery is usually performed before the child is three years old. From now on, parents must pay close attention to the child’s hand and finger movements and compensate for them if necessary. Early medical treatment can prevent joint deformation, especially if the fingers are not of the same length. The prerequisite is that the child will also receive medical support after the procedure. The task of the parents is to monitor the course of the disease and the intake of any prescribed painkillers.

Syndactyly