Symbrachydactyly (Short, Joined Fingers)

What is symbrachydactyly?

Symbrachydactyly is the medical term for a birth defect that causes your baby to be born with short and/or joined digits — fingers and thumbs. It’s a congenital hand difference.

Symbrachydactyly is pronounced, “sim-BREAK-EE-DACK-til-EE.”

Your healthcare provider will diagnose your baby with symbrachydactyly right after they’re born. Many babies with symbrachydactyly eventually need surgery to reshape their hand and give it as much function as possible.

How common is symbrachydactyly?

Symbrachydactyly can affect any newborn baby, but it’s rare. Around 1 in 32,000 babies born each year has some form of symbrachydactyly.

How does symbrachydactyly affect my baby’s body?

Symbrachydactyly can impact your child’s ability to use their hand. It also affects the physical appearance of their hand. Even after surgery and other treatment it’s unlikely your child’s hand will have full function.

Symbrachydactyly is usually unilateral, meaning it usually only affects one of your baby’s hands.

Your healthcare provider will classify the symbrachydactyly as one of four types.

Symbrachydactyly types

The four types of symbrachydactyly include:

• Short-finger symbrachydactyly (Type 1): Having all or most of a thumb and four fingers. The digits that do form might have missing bones (phalanges) and will be noticeably shorter than typical fingers.
• Oligodacylic symbrachydactyly (Type 2): Having a thumb and pinkie finger, but no digits between them. You might see this referred to as an atypical cleft hand.
• Monodactylic symbrachydactyly (Type 3): Having only a fully developed thumb. The other four fingers might be partially developed but missing bones, muscles or other tissue. You might see these partially formed digits referred to as remnants or nubbins.
• Peromelic symbrachydactyly (Type 4): Having no fingers or a thumb.

No matter which type of symbrachydactyly your child has, your healthcare provider will diagnose it right after your baby is born and will likely refer you to a pediatric hand surgeon.

What are the symptoms of symbrachydactyly?

The only symptom of symbrachydactyly is your child being born with short and/or joined fingers that affect one of their hands.

Depending on which type of symbrachydactyly your baby has, their fingers may have abnormalities of:

• Bones.
• Muscles.
• Ligaments.
• Tendons.
• Nerves.

What causes symbrachydactyly?

There’s no known cause of symbrachydactyly. Some experts think it’s caused when something cuts off blood flow to your baby’s arm as it’s developing in the womb. You might see this referred to as “vascular dysgenesis,” which is the medical term for improper development because of a lack of blood flow.

Unlike other congenital hand differences, symbrachydactyly isn’t caused by a genetic disorder — it’s not a hereditary issue. This means that biological parents can’t pass symbrachydactyly to their children.

How is symbrachydactyly diagnosed?

Your healthcare provider will diagnose symbrachydactyly when your baby is born. They’ll identify any issues with your baby’s hands or fingers, and will diagnose a type of symbrachydactyly.

What tests will be done to diagnose symbrachydactyly?

Symbrachydactyly doesn’t usually need any tests to diagnose it. You’ll be able to see your baby’s affected hand as soon as they’re born. Your healthcare provider might be able to diagnose symbrachydactyly before your child is born with a prenatal ultrasound.

Your baby might need an X-ray of their hand by a healthcare provider that treats the symbrachydactyly.

How is symbrachydactyly treated?

Symbrachydactyly is usually treated with surgery. Which type of operation your baby will need depends on which type of symbrachydactyly they have. Your healthcare provider might not recommend surgery until your baby is around 1 to 2 years old.

Your surgeon will perform a symbrachydactyly surgery to restore as much function and typical appearance to your baby’s hand as possible. Several surgeries may be required.

They might be able to release flaps of skin or other tissue to make it possible for your child to pinch and grab with their affected hand. Sometimes, your surgeon might recommend transferring a toe from your baby’s foot to their hand. This shouldn’t affect their ability to stand, walk or move on that foot in the future, but can greatly increase how much your child can use their hand. Your surgeon will explain which type of surgery your child will need and what to expect. Early treatment before full development is important in this case.

Nonsurgical symbrachydactyly treatment

Some children with symbrachydactyly benefit from nonsurgical treatments either before or after surgery. Wearing a brace or splint on their hand can help spread and strengthen any digits they have. Some children can wear a prosthesis (artificial hand) to help them hold and grab things.

Physical therapy to help your child learn how to use their hand as best as possible is also an option. Talk to your healthcare provider about which treatments will help your child, especially as they get older.

How long does it take to recover from symbrachydactyly surgery?

It depends on which type of surgery your child needs. Your healthcare provider or surgeon will tell you how to care for your baby’s hand after their symbrachydactyly surgery.

How can I prevent symbrachydactyly?

You can’t prevent symbrachydactyly from developing during your pregnancy. However, birth defects are linked to certain activities, including:

• Drinking alcohol.
• Smoking or using tobacco products.
• Using recreational drugs.

Talk to your healthcare provider about what you should avoid eating, drinking or doing while you’re pregnant.

What can I expect if my baby has symbrachydactyly?

No matter which type of symbrachydactyly your baby is diagnosed with, it should have no impact on their general growth or development.

If symbrachydactyly is diagnosed alongside another birth defect or another condition, your child might need other kinds of treatment or care. Talk to your healthcare provider about what to expect.

When should I see my healthcare provider?

Talk to your healthcare provider if you notice any changes in your baby’s hands. See them if your child’s surgery site has any of the following symptoms:

• Bleeding.
• Discoloration.
• Swelling.
• Discharge or leaking fluid.
• Your baby is in pain or seems unusually agitated.

What questions should I ask my doctor?

• What type of symbrachydactyly does my baby have?
• Which type of surgery will they need?
• How many surgeries will they need?
• How old will they be when they need surgery?
• Will my baby need physical therapy or other, nonsurgical treatments?

A note from Cleveland Clinic

Symbrachydactyly is a condition that causes your baby to be born with short and/or joined fingers and thumbs. It can affect your baby’s ability to use their hand their whole life. But being born with a congenital hand difference doesn’t mean your child won’t be happy and healthy. They’ll probably need surgery to improve how well they can use their hand, and some therapy to improve their hand’s function after that. But symbrachydactyly won’t affect any other part of their growth or development.

Talk to your healthcare provider about what to expect. They’ll help you understand what you need to know every step along the way.