FINGERED FINGERS OR SYNDACTY: ALL ABOUT THE MAIN

Today we will talk about such a disease as syndactyly.
WHAT IS SYNDACTY?
Syndactyly is a congenital union of two or more fingers on the hands or feet. The key feature of this pathology is that the fingers or toes grow together.
The disease can be present on one or more limbs. In addition, syndactyly of the arm or leg may be accompanied by other limb deformities associated with abnormal joint development.
STATISTICAL DATA
Syndactyly accounts for about 50% of congenital anomalies of the upper extremities. According to statistics, pathology occurs in 10% of newborns.
In girls, pathology is less common than in boys, since very often the mutating gene is transmitted precisely through the male line.
WHEN DOES THE PATHOLOGY APPEAR?
Pathology manifests itself at 4-8 weeks of gestation, when the embryo starts laying and forming a hand. This malformation occupies more than half of all hand and foot anomalies.
TYPES OF SYNDACTY
Syndactyly on the legs, as well as on the hands, is of two types, depending on the type of fusion:

• Soft tissue form, in which only soft tissues grow together, while bones can fully develop.
• Bony form, in which the fusion of the bony fingers is complicated by the fact that there is a partial or complete adhesion of the phalangeal bones.

WHAT ARE THE CAUSES OF THE DISEASE?
The main cause of syndactyly is a hereditary factor transmitted in an autosomal dominant way. However, if there were no cases of syndactyly in the family, then the cause of the anomaly is the unfavorable course of pregnancy, provoked by negative factors, such as:

• taking medications,
• alcohol,
• ecology,
• work in hazardous production,
• X-ray irradiation,
• infectious diseases during pregnancy.

Very often, the reasons for the formation of syndactyly remain unclear.
SYMPTOMS OF SYNDACTY
The main symptom of syndactyly is the presence of spliced ​​fingers, which is evident on the first examination of a newborn baby. The shape and type of fusion can be different, depending on whether the fusion is soft or bone, full or incomplete, with deformation of the fused fingers or not. With bilateral syndactyly, symmetrical fusion is usually observed.
With soft tissue adhesion, the functions of the hand are practically not disturbed, which allows children with this type of pathology to perform a fairly wide range of actions.
WHAT ARE THE DIAGNOSTIC METHODS OF THIS PATHOLOGY?
The diagnosis of syndactyly is established immediately after birth on the basis of an external examination of the child. To accurately determine the form of the defect and select the most appropriate treatment tactics, a number of studies are being carried out:

• ultrasound dopplerography;
• radiography;
• angiography;
• electrothermometry. 

Also, to exclude chromosomal, gene abnormalities, it is recommended to consult a geneticist.
WHAT DOCTOR TREATS THIS DISEASE?
As a rule, syndactyly is treated: at the stage of diagnosis – a neonatologist, at the stage of treatment – a surgeon and a pediatric orthopedist.
TYPES OF SYNDACTY
The typification of syndactyly is carried out: in form and in structure.
In particular, according to the form of the disease, 5 types of syndactyly are distinguished:

• Type 1 (zygodactyly): complete or partial membranous fusion of the middle and ring fingers of the hands, or the second and third toes. Webbing between other fingers is possible;
• type 2 (synpolydactyly): fusion of the middle and ring fingers of the hands and simultaneous doubling of the ring finger; fusion of the fourth and fifth toes with a doubling of the little finger;
• type 3: complete bilateral fusion of the ring finger and little finger, shortening of the little finger due to the undeveloped or missing middle phalanx;
• Type 4 (Haas type): complete bilateral cutaneous fusion, as a result of which the hand becomes spoon-like;
• Type 5 is characterized by complication of syndactyly by synostosis of the metacarpal and metatarsal bones, mainly observed between the ring and middle fingers of the hand, on the legs – between the second and third.

By structure, there are 4 such types of syndactyly:

• bone, in which there are bony adhesions of the fingers;
• cutaneous syndactyly – the connection of the fingers with a soft membrane, often running along its entire length;
• terminal, in which the ends of the phalanges of the fingers are spliced;
• cutaneous membranous syndactyly – the connection of the fingers with a small skin bridge.

TREATMENT OF SYNDACTY
Syndactyly is treated by surgery. In cases with fusion of toes, the operation is performed only if the pathology interferes with walking. The method that will be used for the operation and the time of its implementation is determined depending on the form of the pathology and its nature. The most suitable age for the operation is considered to be 4-5 years. In cases with the terminal form of syndactyly, the operation is performed at the age of 6 to 12 months, to prevent uneven growth and secondary deformity of the fingers.
OPERATION METHODS
There are five methods of performing the operation, the most difficult of which is a multi-stage intervention, in which, in addition to separation, bone, muscle, tendon and skin plastics are performed. The simplest intervention is the separation of the membrane, which does not require plastic surgery.
For 3-4 months after the operation, a removable plaster splint is applied to the hand. Physiotherapy begins two weeks after the operation.
It is important to note that in the vast majority of cases, the simple (cutaneous) form of toe syndactyly does not cause functional problems.
FAMOUS PEOPLE WITH SYNDACTY
Among people suffering from this disease, there are well-known personalities. For example, Stalin’s second and third toes on his left foot were fused from birth. The American actor Ashton Kutcher also suffers from this disease, who is not at all shy of him, and even periodically shows his fused fingers on camera.
If you or your child suffers from this disease, our clinic will be happy to help you solve this problem and live a full life!
Your «Ladisten Clinic».