26562 Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)

Name of the Procedure:

Repair of Syndactyly (Webbed Finger); Complex (e.g., involving Bone, Nails)

Summary

The repair of syndactyly is a surgical procedure to separate webbed fingers. This complex version involves bones and nails, correcting the condition to restore normal finger function and appearance.

Purpose

This procedure addresses the congenital condition known as syndactyly, where two or more fingers are fused together. The goals are to separate the fused digits, allowing for improved function, appearance, and mobility of the fingers.

Indications

• Presence of webbed fingers involving bones and/or nails.
• Limited hand function due to fused fingers.
• Cosmetic concerns due to the webbed appearance.

Preparation

• Patients may need to fast for several hours before the procedure.
• Detailed medical history and physical examination.
• Preoperative imaging tests like X-rays or MRI to assess bone involvement.
• Blood tests and anesthesia evaluation.

Procedure Description

1. The procedure begins with administering general anesthesia to ensure the patient is unconscious and pain-free.
2. The surgeon makes precise incisions along the webbing to separate the fused fingers.
3. If bones are involved, the surgeon carefully separates and reshapes them as needed.
4. Nail reconstruction might be required if the nails are involved in the fusion.
5. Skin grafts or flaps are often used to cover the open areas once the fingers are separated.
6. The surgical area is then stitched up, and the hand is bandaged.

Duration

The surgery typically takes 2 to 4 hours, depending on the complexity and number of web spaces involved.

Setting

The procedure is performed in a hospital or specialized surgical center equipped for pediatric or complex hand surgeries.

Personnel

• Orthopedic or plastic surgeon specialized in hand surgery.
• Surgical nurses.
• Anesthesiologist.
• Surgical technician.

Risks and Complications

• Infection.
• Scarring.
• Anesthesia-related risks.
• Finger stiffness or limited mobility.
• Abnormal wound healing.
• Need for additional surgeries.

Benefits

• Improved finger function and mobility.
• Enhanced hand appearance.
• Boost in the patient's ability to perform daily activities. The benefits generally start to become evident within weeks to months after surgery, following the healing process.

Recovery

• Postoperative care includes hand elevation, pain management, and avoiding strenuous activities.
• Hand splints or bandages to protect the surgical site.
• Physical therapy might be necessary to improve range of motion.
• Follow-up visits for monitoring healing and removing stitches.
• Full recovery may take several months.

Alternatives

• Non-surgical management is generally not effective for syndactyly involving bones and nails.
• The only alternative is less invasive surgery for less complex cases, though it may not be suitable for complex syndactyly.

Patient Experience

• Post-surgery, patients may experience pain and swelling, managed with medications.
• Temporary movement restrictions of the hand, requiring assistance with daily tasks.
• Psychological support may be beneficial for younger patients adjusting to changes and recovery.