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Syndactyly isn't rare, but the specialized treatment offered by our award-winning team of pediatric orthopedic surgeons is.

If your child was born with webbed fingers and/or toes, they have a congenital condition called syndactyly – and they're not alone. The most common hand difference present at birth (congenital), syndactyly affects about one in every 2,500 babies each year and ranges in severity. Boys are more likely than girls, and Caucasians are more likely than African Americans or Asians to be diagnosed with syndactyly.

Our orthopedic surgeons understand the challenges webbed fingers and toes may cause. After a careful examination, which will likely include X-rays, a physician will diagnose your child with one of several types of syndactyly, depending on how their fingers and/or toes are joined together.

After your child is diagnosed, our team works with you and your child to determine the best course of treatment. Typically, surgery is performed early on to separate conjoined fingers and ensure your child's hand functions correctly throughout his or her life. However, if syndactyly affects the toes, treatment may not be necessary because conjoined toes rarely cause functional issues.

Our surgical outcomes are incredibly positive, particularly in cases of incomplete simple syndactyly. In fact, once healed, rarely can you tell there was a need for the fingers to be surgically separated.
Michael Wattenbarger, M.D., chief of staff, Greenville

Types and Causes of Syndactyly

Four different terms are used to diagnose syndactyly: incomplete simple, incomplete complex, complete simple, complete complex.

Incomplete: Only part of adjacent fingers or toes are webbed or connected.

Complete: Fingers or toes are joined all the way, from base to tip.

  • If syndactyly affects your child's three middle fingers, it is important to consider surgically separating the fingers before age 2 so that he or she may develop age-appropriate fine and gross motor skills.
  • If the thumb or small finger are affected, surgical separation is usually suggested prior to the child's first birthday. This is because the thumb and small finger are significantly different lengths than their neighboring fingers. Early separation will allow all affected fingers to develop more normally and grow equally.

Beyond incomplete or complete, the diagnosis then moves one step further to simple or complex.

Simple: Fingers or toes are joined by skin and soft tissue only.

Complex: Fingers or toes are joined by skin, soft tissue and underlying bones.

  • To prevent the boney fusion of fingers from worsening, surgery is generally recommended prior to age 1 for complex cases. Early intervention will allow the digits to grow more normally.

Causes of Syndactyly

Most types of syndactyly happen in the womb during development of the hand and arm. Normally, the hand forms in the shape of a paddle. Then, at about the sixth or seventh week of gestation, the hand shape splits into fingers. If there's an irregularity in the process, fingers and/or toes might fail to divide correctly.

About 50% of the time, syndactyly affects both hands (bilateral) and most often occurs between the middle and ring fingers. While syndactyly can happen for no apparent genetic reason, about 10 to 40% of cases are the result of an inherited trait or genetic syndrome. Syndactyly is also associated with approximately 300 different genetic syndromes.

female cleft lip patient in bed, smiling

Pediatric Surgery

We understand just how complex surgery for children can be. Typically more complicated than operating on adults, exceptional pediatric surgery requires a team of physicians – world-renowned physicians like those found at Shriners Children's – who offer a range of specialized technical skills. With a deep understanding of what successful outcomes can mean to children and their families, all of our surgeons have what it takes to deliver truly life-changing care.

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Next Steps

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