Syndactyly

Syndactyly Fourth 30% second 15% Third 50% first 5% Abnormalities. Nails-N.V-skeleton-tendon Complete- incomplete -Complex-Complitcated Third-w.s most-50% shaped-long-ring Pathology-calssification U shaped index small finger V 3-4 ANATOMY

PREOPERATIVE evaluation

The extent of the syndactyly-nail-other anomalies

Examination

shoulder- entire upper-limb

• hand

• chest wall and

• the feet

Management

cosmetic

functional

developmental on growing child

Timing of surgery

18 months The first procedure First and second Third and forth

Contraindications medical conditions that preclude surgery or

complex synd that risk future functional impairment with attempted separation

on occasion there are insufficient components in the fused mass to produce independent stable and Mobil digits ( central brachysynd or synpolydactyly

mild incomplete synd without functional impairment

Paronychial fold

COMPLICATIONS

V.A infection-Wound dehiscence- graft loss

OVER TIME→ WEB creep- joint contractures

Beaked nail deformity

joint instability

COMPLICATIONS

Special cases of synd

Acrosyndactyly

Aper’s syndrome

Symbrachydactyly

Poland syndrome