Syndactyly: a review of the factors which influence surgical treatment.

A review was undertaken of 100 patients with 218 surgically-treated syndactylies operated upon over a ten year period. The pre-operative factors which influenced the result of surgical treatment were the complexity of the syndactyly and the presence of other congenital abnormalities in the hand. The operative factor which most influenced outcome was the type of skin-graft used. 42 patients required at least one secondary operation to obtain an acceptable result, comprising 22% who developed web creep and 26% a significant flexion contracture; five patients developed both a contracture and web creep. In contrast, the type of flap used to reconstruct the web floor had little influence on the result.