eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Syndactyly: Workup

Author: E Gene Deune, MD, Associate Professor of Orthopedic Surgery, Associate Professor of Plastic Surgery, Co-Director, Division of Hand Surgery, Director, Hand Surgery Section and Pediatric Hand Surgery, Johns Hopkins University School of Medicine
Contributor Information and Disclosures

Updated: Feb 5, 2009

Workup

Imaging Studies

  • Obtain radiographs of the hands to evaluate for any other bony anomalies, such as synostosis, delta phalanx, or symphalangism.

Diagnostic Procedures

If the infant has no associated medical conditions, a formal preoperative evaluation by the anesthesia team is usually not necessary.  However, should there be any congenital syndromes or associated medical conditions, the patients should be scheduled for operative clearance with the preoperative evaluation service of the hospital where the surgery will be done.  Generally, if there is no issue with postoperative monitoring, many of these cases can be handled as outpatient procedures.

More on Syndactyly

Overview: Syndactyly
Workup: Syndactyly
Treatment: Syndactyly
Follow-up: Syndactyly
Multimedia: Syndactyly
References

References

  1. Schwabe GC, Mundlos S. Genetics of congenital hand anomalies. Handchir Mikrochir Plast Chir. 2004;36:85-97. [Medline].

  2. Mandal K, Phadke SR, Kalita J. Congenital swan neck deformity of fingers with syndactyly. Clin Dysmorphol. Apr 2008;17(2):109-11. [Medline].

  3. Flatt AE. The Care of Congenital Hand Anomalies. St Louis, Mo: Quality Medical Publishing; 1977.

  4. Poland, Alfred. Deficiency of the pectoral muscles. Guy's Hospital Reports. 1841;VI:191-193.

  5. Upton J. Apert syndrome. Classification and pathologic anatomy of limb anomalies. Clin Plast Surg. Apr 1991;18(2):321-55. [Medline].

  6. De D, Narang T, Kanwar AJ, Dogra S. Brachycephaly and syndactyly: Apert's syndrome. Indian J Dermatol Venereol Leprol. Jul-Aug 2008;74(4):395-6. [Medline].

  7. Patterson TJ. Congenital ring constriction. Br J Plast Surg. 1961;14:1–31. [Medline].

  8. Percival NJ, Sykes PJ. Syndactyly: a review of the factors which influence surgical treatment. J Hand Surg [Br]. May 1989;14(2):196-200. [Medline].

  9. Eaton CJ, Lister GD. Syndactyly. Hand Clin. Nov 1990;6(4):555-75. [Medline].

  10. Lamb DW, Wynne-Davies R, Soto L. An estimate of the population frequency of congenital malformations of the upper limb. J Hand Surg [Am]. Nov 1982;7(6):557-62. [Medline].

  11. Light TR. Congenital anomalies: syndactyly, polydactyly, and cleft hand. In: Peimer CA, ed. Surgery of the Hand and Upper Extremity. New York, NY: McGraw-Hill: 1996: 2111-44.

  12. Man LX, Chang B. Maternal cigarette smoking during pregnancy increases the risk of having a child with a congenital digital anomaly. Plast Reconstr Surg. Jan 2006;117(1):301-8. [Medline].

  13. Agarwal A. Comment on Shevtsov and Danilkin: Application of external fixation for management of hand syndactyly. Int Orthop. Jul 16 2008;[Medline].

  14. Frick L, Fraisse B, Wavreille G, Fron D, Martinot V. [Results of surgical treatment in simple syndactily using a commissural dorsal flap. About 54 procedures]. Chir Main. Apr-Jun 2008;27(2-3):76-82. [Medline].

  15. Upton J. Congenital anomalies of the hand and forearm: syndactyly. In: McCarthy JG, ed. Plastic Surgery. Philadelphia, Pa: WB Saunders Co: 1990: 5279.

  16. Sharma RK, Tuli P, Makkar SS, Parashar A. End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects. Hand (N Y). Sep 19 2008;[Medline].

  17. Dillon CK, Iwuagwu F. Cavi-care dressings following syndactyly correction. J Plast Reconstr Aesthet Surg. Sep 24 2008;[Medline].

  18. Barot LR, Caplan HS. Early surgical intervention in Apert's syndactyly. Plast Reconstr Surg. Feb 1986;77(2):282-7. [Medline].

  19. Colville J. Syndactyly correction. Br J Plast Surg. Jan 1989;42(1):12-6. [Medline].

  20. Wu JC, Cunningham BB. Ectopic acanthosis nigricans occurring in a child after syndactyly repair. Cutis. Jan 2008;81(1):22-4. [Medline].

Further Reading

Keywords

syndactyly, simple syndactyly, incomplete simple syndactyly, complete simple syndactyly, complex syndactyly, complicated syndactyly, type I acrocephalosyndactyly, acrocephalosyndactyly, Apert syndrome, type I Apert syndrome, type II Apert syndrome, type III Apert syndrome, Apert's syndrome, Apert syndactyly, Poland syndrome, constriction band syndrome, polydactyly, cleft hands, ring constrictions, brachysyndactyly, symbrachyphalangisms, spade hands, mitten hands, spoon hands, rosebud hands, hoof hands, Holt-Oram syndrome, congenital hand deformity, congenital syndromes

Contributor Information and Disclosures

Author

E Gene Deune, MD, Associate Professor of Orthopedic Surgery, Associate Professor of Plastic Surgery, Co-Director, Division of Hand Surgery, Director, Hand Surgery Section and Pediatric Hand Surgery, Johns Hopkins University School of Medicine
E Gene Deune, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Hand Surgery, American Association of Plastic Surgeons, American Society for Reconstructive Microsurgery, American Society of Plastic Surgeons, and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Medical Editor

A Lee Osterman, MD, Director of Hand Surgery Fellowship, Director, Philadelphia Hand Center; Director, Professor, Department of Orthopedic Surgery, Division of Hand Surgery, University Hospital, Thomas Jefferson University
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Michael Yaszemski, MD, PhD, Associate Professor, Departments of Orthopedic Surgery and Bioengineering, Mayo Foundation, Mayo Medical School
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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