European Journal of Plastic Surgery

, Volume 41, Issue 3, pp 259–268 | Cite as

Progress in surgical strategies for treatment of simple congenital syndactyly: A systematic review

  • Jia TianEmail author
  • Till Wagner
  • Inge Hoevenaren
  • Tycho Wesselius
  • Arico Verhulst
  • Dietmar Ulrich



Plenty of surgical strategies for treatment of simple syndactyly have been reported in the past decades. We are most interested in what progresses have been made over the recent 10 years. Our aim was to make a summary of the modified techniques that have been described in the last decade.


We reviewed English articles from PubMed and Chinese articles from CKNI and CQVIP published between January 2007 and December 2016. We limited the inclusion criteria to simple syndactyly and excluded complex, complicated, and syndrome-associated syndactylies.


We identified 1650 articles and selected 94 for inclusion. Almost half of the included papers proposed modified flaps for web reconstruction. In most cases, a zigzag incision and Buck-Gramcko flaps were still the first choice to separate the fused digits and create the nail folds. Several new donor sites were recommended for skin grafts and several substitute biomaterials were introduced to replace skin grafts. External fixator devices were applied in a wider range for desyndactylization. However, it was not considered to be superior to other graft-less strategies. Postoperative complications were discussed in most papers, but an effective strategy to eradicate these is lacking.


With the development of biomaterials and surgeon’s experiences, more and more modified techniques have been conceived. However, no specific technique can be announced to be superior to others. Furthermore, more sensitive outcome measures should be established, and relationship between operative procedures and postoperative complications should be further defined.

Level of evidence: not ratable.


Simple congenital syndactyly Desyndactylization Web reconstruction Skin grafts 


Compliance with ethical standards

Conflict of interest

Jia Tian, Till Wagner, Inge Hoevenaren, Tycho Wesselius, Arico Verhulst, and Dietmar Ulrich declare that they have no conflict of interest.

Funding support

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Hand Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  2. 2.Department of Plastic and Reconstructive SurgeryRadboud University Medical CenterNijmegenNetherlands

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