Like most things, I take vacation very seriously. No work, no studying, and definitely no newsletter writing. Not even pre-writing a Monday issue when your flight lands at 9 PM on Sunday.
However, I’m back now!
What I learned today
In general, syndactyly = fusion of adjacent digits (soft tissue, bone, or both). Isolated syndactyly occurs in ~1 in 2000, 50% bilateral, with 10-40% of cases demonstrating a positive family history.
Most common: long+ring finger (57%), then ring+small finger (27%).
Complete: webspace extends to include the fingertip
Incomplete: webspace occurs anywhere between normal and the fingertips
Simple: only skin or soft tissue connections
Complex: involves skeletal anomalies (most common: fused distal phalangeal tufts)
[Complex] complicated: accessory phalanges or digits are interposed within the web space
Acrosyndactyly
= syndactyly where a small opening occurs proximal to the distal fusion. Characteristically associated with constriction ring syndrome, 50% bilateral, 50% with absent digits.
Management is variable and depends on the specific patient’s pattern. The syndactyly can range from simple to complex, with a jumble of fingertips distally. Additionally, the sinus can vary widely in size.
Perhaps more on the management techniques to come tomorrow…
Some apply-your-knowledge questions:
How would you classify this?
What would you most likely classify this and how can you tell?
Again, all will be revealed tomorrow.
Sources
Green’s Operative Hand Surgery 7th ed