Plastic surgery of syndactyly (webbed fingers) in children under 2 years old
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Syndactyly, or webbed fingers, is the most widespread defect of the child’s hand. It is characterized by the abnormal connection of fingers or toes. Typically syndactyly involves two fingers – the middle and ring, the thumb and pointer. They may be connected only by skin or, in more severe case, have common bones as well.
The disease is not caused by the compression of fingers in the womb or other external factors. It arises due to the primary defect of fingers formation. At the early stages of development the hand is solid, all fingers are webbed. And this is normal. Later, the excessive tissue is resolved and the hand gains its normal form.
If this process is interrupted, a child is born with syndactyly. Fingers will not separate by themselves without medical assistance. Fortunately, the leading world’s clinics offer microsurgical interventions, which can fix the problem even in newborns, during the first month of life.
Content
- Can I recognize syndactyly by myself?
- Which types of syndactyly exist?
- What should we expect from treatment?
- Will we have to regularly visit a doctor after treatment?
- Which hospitals are thought to be leading in the syndactyly treatment?
- Arrangement of treatment in the leading hospitals abroad
Can I recognize syndactyly by myself?
Yes, you can. Syndactyly is perfectly seen with the naked eye. A neonatologist will make the preliminary diagnosis right after the first physical examination of the child. Further diagnostics will be performed in order to specify the type of syndactyly.
X-ray examination is the most simple and rather informative procedure. X-rays will reveal if fingers are connected only with the soft tissues or the bones are involved in the process as well. In more complicated cases MRI or CT scan may be required. Tomography gives more detailed information about the bone structure.
In certain cases signs of syndactyly are revealed prenatally, during the screening US examination in pregnancy. Skin interconnections between fingers normally disappear before the 56th day of gestation. Detected later on, they are indicative of syndactyly.
Which types of syndactyly exist?
Not all cases of syndactyly are the same. It can be complete (involving the whole finger length) and incomplete (involving only a part of the finger). Depending on which fingers are webbed, 5 types of the disorder are distinguished:
- Zygodactyly, type 1, is the most widespread form of the pathology. It is characterized by webbing of the ring and long fingers.
- Synpolydactyly, type 2, also affects ring and long fingers – they are webbed and the additional ring finger is present.
- Ring-small syndactyly, type 3, usually occurs on both hands. In more severe cases the distal phalanges may be fused.
- Haas-type syndactyly, type 4, is a rare form of the pathology in which all fingers are webbed. The hand is deformed, it is cup-shaped.
- Type 5, without the specific name, is the combination of webbed ring and long fingers with webbed second and third toes.
Syndactyly is always an inborn condition. It may also be a component of a complex genetic syndrome, e.g. Saethre-Chotzen syndrome and Apert syndrome. In this case correction of the fingers’ state can fade into the background giving way to solving the issues with more significant health risks (e.g. heart defects).
What should we expect from treatment?
Treatment of syndactyly is always surgical. There is no other effective way to separate fingers. Performed timely and in the good hospital, surgery allows:
- Improving appearance of the hand, correcting the cosmetic defect.
- Preventing deformity progression during the hand growth.
- Preserving normal function of the upper extremity.
The operation is not limited to simple skin incision, because the existing skin is often not enough for covering two separate fingers. Thus, the defect is carefully reconstructed with a series of skin flaps. Sometimes skin graft transplantation is required to cover the whole surface and provide good cosmetic and functional result. Skin grafts may be taken from the groin or the front of the elbow. Another option is using the skin from the top of the hand, which is less traumatic and prevents scar formation.
When syndactyly involves bones, more complex intervention is required. Bone connections are usually formed near the fingernails and can often be separated the same way as the “simple skin webs”. The problem is, fingers typically stay deformed (e.g. rotated or angled). Additional surgical interventions are performed in such case.
The best age for undergoing treatment depends on the syndactyly type. When we talk about the connection between the ring and small finger or the thumb and pointer finger, it is better to carry out the surgery early enough (about 6 months old). Other types are less significant functionally, so they may be treated later (up to 2 years old).
Will we have to regularly visit a doctor after treatment?
Yes, you will have to visit clinic regularly, but only during the first few months. Right after the surgery the hand will be protected with a bulky soft dressing. It will cover the hand and forearm. Additional rubber spacer may be placed between the affected fingers in order to prevent syndactyly relapse during the wound healing.
One of the main aims in the postoperative period is avoiding scar formation. Reconstructed skin may be substituted with the connective tissue during healing. Connective tissue closes the wound surface effectively and fast. The problem is, it cannot stretch. Thus, fingers lose normal form and function. The repeated surgery is performed in such cases.
In the specialized hospitals abroad physical therapy is administered as the rehabilitative measure. It helps in avoiding stiffness and swelling, restores normal volume of movements. All procedures are performed under the strict guidance of qualified healthcare professional.
Which hospitals are thought to be leading in the syndactyly treatment?
Clinics of the European countries with advanced medical systems are in the lead of the plastic surgery sphere. Equipment for precise (up to the cellular level) interventions, 3D planning of the optimal esthetic result and high competence of surgeons contribute to the maximum treatment success. Plastic surgery in Germany combines low health risks with the most beneficial functional outcomes, which is extremely important in children’s therapy.
List of the best clinics in Germany that show the most beneficial results in syndactyly treatment includes:
- HELIOS Clinic Krefeld, Department of Plastic, Aesthetic and Reconstructive Surgery.
- University Hospital of Ludwig Maximilian University of Munich, Department of Hand Surgery, Plastic and Aesthetic Surgery.
- Hospital Waldbrol Oberberg, Department of Otolaryngology, Plastic Surgery, Facial Surgery.
German hospitals provide help to both children and adults with this problem. Doctors there also perform revision interventions and correct complications of previously performed surgeries (unfortunately, this is a widespread situation in children who undergo surgeries in the improper healthcare institutions). Specialists in Germany provide comprehensive treatment program – from the initial diagnostics to full functional recovery after the surgery.
Arrangement of treatment in the leading hospitals abroad
If you want your child to undergo the plastics of webbed fingers in Germany, you should take care about a number of issues. The first one is choosing the most suitable hospital and receiving permission to be treated there. Treatment of children is a great responsibility and not all hospitals and doctors are ready to take it. Then you should take care about all medical and administrative documents for medical trip abroad. Pay attention to the translation – medical reports should be in German. After finding the accommodation, you may proceed to looking for an interpreter who will accompany you in the clinic.
More simple and comfortable way of making your child healthy is using services of Booking Health. Booking Health is the medical tourism operator that arranges treatment abroad for children and adults from 75 countries. Doctors and support specialists of Booking Health will assist you in:
- Choosing the best hospital exactly for your child
- Establishing communication with your doctor, discussion of the preliminary treatment plan
- Providing favorable cost for treatment, avoiding overpricing and additional fees for the international patients (saving up to 50%)
- Booking the convenient surgery date
- Additional independent monitoring of the treatment program
- Communication with the clinic after treatment completion, arranging control examinations and distant consultations
- Strict financial control, return of unspent funds
- Booking accommodation and plane tickets, transfer organization
- Interpreter services
In addition, you personal medical coordinator will be in touch with you 24/7, so you may feel yourself protected and safe.
Choose treatment abroad and you will for sure get the best results!
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
IMTJ - International Medical Travel Journal
NORD - National Organization for Rare Disorders
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