This is a baby with congenital complex syndactyly in both hands, with different conditions on each side. Left hand: syndactyly between the thumb and index finger, and between the middle and ring fingers, giving the appearance of only three fingers. Right hand: complete osseous syndactyly between the middle and ring fingers, with clear bony fusion of the distal, middle, and proximal phalanges, making the hand appear to have four fingers at first glance.
One-year comparison before and after surgery (left hand)
One-year comparison before and after surgery (right hand)
At 7 months of age, we successfully performed simultaneous bilateral syndactyly separation surgery. Instead of traditional skin grafting, artificial dermis was used to cover the wounds, successfully separating the child's 7 fingers into 10. Now, more than one year after surgery, both the appearance and function of the hands have recovered well, and the child can grasp and use the fingers freely.
When we first met the baby's parents, they were extremely anxious because the syndactyly in both hands was indeed quite complex. Their main concerns were:
1.Can the fingers be separated at all?
2.If separation is possible, can both hands be operated on in one surgery?
3.How will the postoperative wounds be managed, especially the osseous syndactyly in the right hand?
4.What will finger function be like after separation?
Can all syndactyly be separated?
The parents' foremost concern was:The syndactyly in both hands is so complex-especially with the bones fused in the right hand-can the fingers really be separated?
After thorough evaluation, the answer was yes. Although the osseous syndactyly between the right middle and ring fingers was severe, imaging studies showed that each finger still had relatively independent bony structures, providing a reliable anatomical basis for surgical separation. The syndactyly of the left thumb–index finger and middle–ring finger also met the criteria for separation.
Preoperative X-rays of both hands
Can both hands be operated on at the same time?
Out of concern for their child, the parents hoped to minimize the number of surgeries: "Can both hands be fixed in a single operation?"
Although the procedure is complex, with an experienced surgical team and meticulous preoperative planning, all steps can be completed safely and efficiently under a single anesthesia. This avoids the child undergoing two rounds of anesthesia and surgical trauma, allows for unified postoperative rehabilitation, and reduces the family's burden of repeated hospital visits.
With so many wounds, how are they covered? Can skin grafting be avoided?
Facing large postoperative wounds-especially areas with bone exposure in the right hand-the parents were very worried:"How will the wounds heal after separation? Is skin grafting unavoidable?"
We used an artificial dermis technique without skin grafting, covering the wounds with artificial dermis. Traditional skin grafting requires harvesting skin from another part of the child's body, creating additional scars, and graft survival rates are relatively low in areas with bone exposure. Artificial dermis acts as a biological scaffold, covering the wound and guiding the child's own skin cells to regenerate and repair. Eventually, the wound is fully covered by autologous skin. This approach avoids donor-site injury and scarring, and the healed skin appears much closer to normal.
Initial consultation photos
After separation, will finger function be good?
This is the ultimate question behind all concerns:"After surgery, will the child's fingers move well? How much function can be restored?"
Functional recovery is a systematic process, depending on the combination of successful surgery + meticulous care + persistent rehabilitation. Surgery creates the possibility for functional recovery. Postoperatively, parents must fully commit-under medical guidance-to a long rehabilitation process, including: Regular functional exercises after wound healing; Scar management to prevent contracture; Night brace to prevent finger deviation.
Function is something that must be trained through use. The earlier and more consistently rehabilitation is performed, the more flexible the fingers become, forming a positive cycle of better function → more use → better development.
One year after surgery: a remarkable transformation
At 7 months of age, the child underwent the planned bilateral syndactyly separation surgery successfully. After surgery, the parents demonstrated remarkable patience and perseverance: they strictly followed wound care protocols, accompanied the child through systematic grasp training, and consistently managed scars and night brace.
Left hand, 7 months after surgery
Right hand, 7 months after surgery
Today, more than one year postoperatively, the child's hands show encouraging improvements. The scars are no longer obvious, finger function has recovered well, and the child can grasp, play, and use the hands freely. Compared with the preoperative state, both appearance and function have been completely transformed. These results are inseparable from the parents' dedication and persistence throughout the long rehabilitation journey.
Left hand, more than 1 year after surgery
Left hand, more than 1 year after surgery
Right hand, more than 1 year after surgery
Right hand, more than 1 year after surgery
We believe that with continued functional training and natural growth, these little hands will continue to improve even further.