Syndactyly
What does someone with syndactyly complain of?
The third web is most commonly involved followed by the fourth and second web successively.
Complex forms that involve fusion of the bones of the hand may distort the shape and growth of the longer of the joined digits.
How is it treated?
The main stay of treatment is surgery and this is to separate the fingers and provide adequate skin cover over the exposed tissues using multiple zig zags flaps of skin.
Due to the inadequacy of skin, skin grafts are also needed and are taken from the groin area or the instep of the soles of the feet.
Anaesthesia
The surgery is usually performed under general anaesthesia if a child or using regional anaesthesia (brachial block) in adults. Local anesthetic is injected into the armpit and this makes the whole arm numb and surgery is performed while patient is awake.
What to expect post operatively?
Stiffness may occur and would usually respond to sustained hand therapy (physiotherapy).
Scars may be swollen and firm for a few months. Massaging the scars with moisturising cream will help soften them.
What are some of the problems that may arise?
Infection can occur as with any surgery and is usually treated with antibiotics.
Minor wound breakdown is not unusual. Simple dressings will suffice.
Partial or total loss of the skin grafts or the flaps (Z-plasty) may occur especially in smokers
Scars especially from skin grafts may become hypertrophic or lumpy. Massage with cream or silicone gel treatment may help. There are also scar treatments performed by the hand therapists that help.