[Results of various operations for syndactylia (follow-up studies and statistical evaluation of 101 primary...

101 cases of syndactyly in 34 male and 14 female infants who were aged three months to seven years at the time of their initial surgery were reviewed one to 9.5 years thereafter. The web space was formed by a palmar and a dorsal flap; in 50% of all commissures the result was found satisfactory in the follow-up series. Straight incision - performed in two thirds of our cases - caused scar contractures and deformities of several fingers. In contrary, zig-zag or wavy incisions showed good results. Using almost exclusively full thickness skin grafts from the arm, the donor site looked poor because of non-cosmetic scares and keloids. After surgery two thirds of all patients used a special splint for finger abduction for an average of about one year; neither an amelioration of insufficient primary surgery was achieved nor reappearance of syndactylism could be avoided by this device. The mobility of joints was partially decreased regardless of the pre-operative condition. Combined functions in grasping, however, were not restricted to a considerable degree. There was no difference between cutaneous and osseous syndactylism with respect to the abduction ability. Even slight impairment of wound healing caused reappearance of syndactylism; reseparation of fingers was necessary 32 times during a ten year period of follow-up. Scar contractures - especially after necrosis of skin grafts and deep infections - required early correction, while slowly developing secondary webs had to be separated some years later. Disturbance of wound healing must, therefore, be treated adequately, or better should be avoided by precise surgery and careful management of postoperative dressing.