Syndactyly

Syndactyly is a congenital condition in which two or more fingers are fused together, either by skin alone (simple syndactyly) or involving underlying bone and joint structures (complex syndactyly). At Olive Skin & Aesthetics, we perform syndactyly separation with meticulous attention to web space creation, skin grafting, and long-term functional outcomes — restoring independent finger movement and normal hand appearance.

Surgery is planned carefully, particularly in cases involving border digits (index-middle or ring-little), where asymmetric growth of fused fingers can cause progressive angulation deformity if correction is delayed. Early surgical separation protects skeletal development and allows the fingers to develop their full functional independence.

• Children with simple (skin-only) or complex (bony) syndactyly of two or more digits
• Cases involving border digit pairs (thumb-index or ring-little) where early separation is urgent to prevent growth deformity
• Patients with associated polysyndactyly requiring combined separation and extra digit removal
• Adults with untreated syndactyly seeking functional and cosmetic correction
• Children aged 6 months and above, cleared for general anaesthesia

Syndactyly separation is performed under general anaesthesia. The fused skin is divided using a carefully designed interdigitating zigzag incision that creates opposing skin flaps — maximising the available skin to line the newly created web space and the sides of each separated finger without straight-line scars that could cause contracture.

Because the shared skin between fused fingers is always insufficient to cover both digits after separation, a full-thickness skin graft (typically harvested from the groin) is used to resurface the areas that cannot be covered by local flaps. A well-formed commissural web space is reconstructed using a dorsally-based flap to prevent proximal web creep.

• Days 1–5: Dressing and splint in place. Graft take period — hand kept elevated and immobilised.
• Week 1–2: First dressing change and graft take is assessed. Splint continued.
• Week 3–6: Splint removed. Gentle finger mobilisation begins. Scar management with silicone gel and compression commenced.
• Month 2–6: Progressive improvement in finger independence and web space depth. Occupational therapy for fine motor skills.
• Ongoing: Annual review to assess for web creep or contracture requiring revision.