This 2004 JAAOS review by Dao et al. covers the full surgical management of congenital syndactyly of the hand — from embryology and classification through operative technique, special cases (complex syndactyly, cleft hand, central polydactyly, acrosyndactyly), and complications. The central question is how to time and execute syndactyly release to maximize function while minimizing reoperations.
When you see a neonate with syndactyly involving the thumb-index or ring-small border digits, plan release by 3–4 months — not the standard 18-month window. To prevent irreversible bony deformity from differential digital growth.
When planning coverage, always use full-thickness skin graft: split-thickness grafts carry an eightfold higher rate of web creep.
This 2004 JAAOS review by Dao et al. covers the full surgical management of congenital syndactyly of the hand — from embryology and classification through operative technique, special cases (complex syndactyly, cleft hand, central polydactyly, acrosyndactyly), and complications. The central question is how to time and execute syndactyly release to maximize function while minimizing reoperations.
When you see a neonate with syndactyly involving the thumb-index or ring-small border digits, plan release by 3–4 months — not the standard 18-month window. To prevent irreversible bony deformity from differential digital growth.
When planning coverage, always use full-thickness skin graft: split-thickness grafts carry an eightfold higher rate of web creep.