Syndactyly of fingers and toes — causes, treatment and pictures pathology
Syndactyly of the toes and brush in children
Syndactyly – abnormal development of the fingers due to the violation of their divisions in the embryonic stage. The disorder is about 50% of all congenital lesions of the hands and occurs with a frequency of 1: 2000.
Can be an independent disorder or be accompanied by other lesions: polivalencia and underdevelopment of the fingers, brachydactylia, from ectrodactyly, disintegrating brushes, etc. in 60% of children with this deviation, there is an additional abnormality of the musculoskeletal system.
The causes of pathology
The reasons for which occurs syndactyly of the toes and brushes lie in the field of genetics. More than 20% of severe are genetic in nature.
In the absence of this factor it is necessary to assume a violation of the separation of the limbs of the fetus under the influence of adverse conditions. Bookmark tassels happens at 5 week of development; at this stage the fruit is a natural characteristic of syndactyly.
The standard development for 8 week laid the fingers. In violation of the appearance of partitions of the fingers are not separated, ie, there is syndactyly.
The causes of pathology can be harmful effects on the expectant mother, x-ray, infection in pregnancy. Often the causes of such a baby are unknown.
The original factors of the pathology should be sought in the composition of genetic and chromosomal abnormalities.
Rarely has a place acquired lesions due to burns of the hand.
Classification of the disease
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In medicine deviation divided by species, length of connections and the condition of the fingers.
In length dependent on the number of fused parts of the fingers, we distinguish complete and incomplete forms. Full — fusion, covering the nail part. Incomplete — fusion of the joints of the phalanges. This form is divided into incomplete basal form and the terminal form.
As the United finger the deviation is simple and complex. For a simple violation occurs connection normal fingers, in complex — modified fingers. Among other things, distinguish hereditary diseases:
- Type I — membranous connection of 3 and 4 fingers; 2 and 3 toes. There are webs between the other toes.
- Type II connection 3 and 4 of the fingers with doubling 4 fingers, 4 fingers and 5 toes with the doubling of the 5 finger.
- Type III – bilateral connection 4 and 5 fingers; the little finger is shortened. Basically, the feet are not affected.
- Type IV – bilateral skin lesion the shape of the brush lokabrenna. Lose stop is not observed.
- Type V – lesions with the connection of bones, pasterns and hocks. On hands — skin connection 3-4 fingers, legs – 2-3 fingers.
A unilateral deviation occurs more often than bilateral; connection of the fingers more often than toes.
Clinical picture of the pathology
With the defeat of the hand is a connection of the middle and ring fingers; legs 2 and 3 fingers. Rarely linked ring and little finger, thumb and index finger, all the fingers. With bilateral lesions, the connection is symmetric.
Indivisible fingers can be a normal or underdeveloped. Sometimes there is a reduction in the number of phalanges.
Under basal lose efficiency brush is almost not affected. But syndactyly in children inhibits the overall development of the child.
Due to limitations or failure of the implementation of the various movements of the fingers suffering from a mental, speech and mental development of the baby. The underdevelopment of the brush complicates studies and limits the choice of profession.
Violation is determined immediately after the appearance of the baby’s neonatologist. Subsequent examinations and monitored the children’s surgeon or podiatrist. To exclude hereditary problems that a child with violations needs to be consulted by a geneticist.
Diagnosis can be made during visual inspection, but to determine the appearance and development of algorithm of treatment it is necessary to conduct research.
X-rays of the hands and feet helps to evaluate joints, bone density, presence and length of the bones. To determine the intricacies of the structure of the vessels of the United parts is rheovasography, Doppler ultrasound, angiography, electrotermometria.
Treatment of the disease
Treatment of syndactyly of the fingers is done only by surgery. If diagnosed with syndactyly of the toes, the operation is not assigned, if the violation does not prevent to walk.
The timing and suitable method of treatments is chosen based on the shape and nature of the lesion.
The purpose of the intervention — the elimination of the external flaw, and brush.
The optimal age for the procedure is 4-5 years. In the end the defeat of the earlier needed surgery, helping to prevent uneven growth and secondary changes of the fingers.
Treatment approaches are divided into groups:
- the separation membrane without plastics;
- the separation of the fingers connected with skin plasty with local tissues;
- cut finger with a free skin plasty;
- separation of the fingers combined with plasticity;
- multistage interference from skin, tendon, muscle and bone plasticity.
After surgery to immobilize the fingers with the limb in a plaster for 4 months.
14 days after intervention starts treatment consisting of massage, exercise therapy, phonophoresis, mud and ozocerite applications.
Prognosis and complications
The applied treatments yield positive results. With timely surgery restores the structure and operation of the brush.
The efficiency of treatment are the lack of deformation and tightening of the scars, full range of motion in the interphalangeal joints, good sensitivity of the fingers.
When failure of treatment deviation adversely affects the growth and development of the limb.