Brachydactyly-Syndactyly Syndrome

Other names
Types
Causes
Symptoms
Diagnostic tests
Non-pharmacological treatments (therapies and other supports)
Drug treatments
Dietary molecular supplements
Immunity-booster / Regenerative / Stem-cell drugs
Surgeries
Preventions
When to see a doctor
Foods to favor and to limit
Frequently Asked Questions (FAQs)

Brachydactyly-syndactyly syndrome is a rare, inherited condition that affects the hands and feet. “Brachydactyly” means the fingers or toes are shorter than usual because some bones are shorter or missing. “Syndactyly” means two or more fingers or toes are joined together by skin or, less often, by bone. In this syndrome, both problems happen together in the same person. Doctors often see short bones in several fingers and toes, wide and short tips of the thumbs, and soft-tissue joining of the second and third toes. Many people have features that overlap with other “brachydactyly types” (like A4, D, or E). Scientists have linked many families to changes in a limb-development gene called HOXD13, which helps guide how fingers and toes form before birth. Most families pass the condition in an autosomal dominant way, so a single changed copy of the gene can cause it. sciencedirect.com+4malacards.org+4uniprot.org+4

Brachydactyly means short fingers or toes. Syndactyly means two or more digits are joined together by skin or, less often, bone. In Brachydactyly-Syndactyly Syndrome (BDSD), both features happen in the same person from birth. A well-described form is the “Zhao type,” where the middle bones of certain fingers are short and some toes are joined together. This pattern comes from differences in how the hand and foot bones form in the womb. Orpha+2National Organization for Rare Disorders+2

During weeks 6–8 of pregnancy, digits normally separate and bones lengthen. In syndactyly, the separation is incomplete; in brachydactyly, the bones are shorter than usual. Some cases run in families, and certain genes that guide limb growth can be involved. Variants in HOXD13 are a known cause of related patterns (like synpolydactyly), and BHLHA9 has been linked to overlapping hand-foot differences in some families. Not every person with BDSD will have an identified gene change, and most children are otherwise healthy. platform.opentargets.org+4chop.edu+4emedicine.medscape.com+4

Key idea: BSS affects shape and length, not brain or organs in most people. Many people have normal health otherwise, but may want evaluation for function, comfort, and appearance. A clinical geneticist and a hand/foot specialist (orthopedic or plastic surgeon) usually guide care. BioMed Central

Other names

This condition can appear under several labels in different resources:

Brachydactyly-syndactyly syndrome (BSS)
Brachydactyly-syndactyly, Zhao type (named after a key research report)
OMIM #610713 disorder (database number)
MONDO:0012544 or DOID:0050689 (ontology IDs used in research)
Phrases like “complex brachydactyly with syndactyly,” or “brachydactyly with cutaneous syndactyly.” monarchinitiative.org+3orpha.net+3sciencedirect.com+3

Types

Doctors sometimes group the finger/toe changes by which bones are short or which digits are joined. In BSS, patterns often overlap:

Overlap with Brachydactyly type A4: short middle bones (phalanges) in the 2nd and 5th fingers; in the feet, middle bones in toes 2–5 may be absent. orpha.net+1
Overlap with Brachydactyly type D: broad, short distal phalanx of the thumb. malacards.org
Overlap with Brachydactyly type E: some shortening in the bones of the hand/foot rays, sometimes including metacarpals/metatarsals. malacards.org
Syndactyly pattern: most often soft-tissue webbing between toes 2–3; sometimes fingers have partial webbing. When bone is fused, doctors call it “complex” syndactyly. radiopaedia.org

These “types” are not separate diseases here; they are descriptions of the bone pattern inside one rare syndrome. The exact pattern can vary within the same family. BioMed Central

Causes

BSS is mainly genetic. Below are direct and indirect causes or contributors that explain why someone has the features, or why features differ between people. Each item has a brief, plain-language explanation.

HOXD13 variants (most established)
A change in this limb-patterning gene can alter how fingers and toes split and grow, leading to short bones and webbing. sciencedirect.com
Regulatory changes near HOX genes
Even if the HOXD13 code is intact, nearby “switches” that control gene timing can cause similar hand/foot patterns. BioMed Central
Dominant inheritance
One altered gene copy can be enough to cause the condition; this explains vertical transmission through generations. BioMed Central
Variable expressivity
The same family mutation can look mild in one person and more marked in another, due to other genes and environment. BioMed Central
Reduced penetrance
Some carriers may show very mild changes or none that are obvious on exam, yet can pass the gene change on. BioMed Central
Changes affecting bone growth plates
If signaling during weeks 4–8 of embryo limb formation shifts, middle or end bones may be shorter or missing. BioMed Central
Abnormal interdigital tissue breakdown
Normally, tissue between digits thins and separates; if this step is incomplete, soft-tissue syndactyly persists. radiopaedia.org
Pathway effects (e.g., Hedgehog/BMP/GDF5 networks)
Limb development uses many signals; small pathway differences can shape the final bone lengths. BioMed Central
Family-specific modifiers
Other inherited variants can make brachydactyly or syndactyly look milder or more severe within a family. BioMed Central
New (de novo) mutations
Sometimes the change is new in the child and not present in the parents. This is uncommon but possible. BioMed Central
Mosaicism
If only some cells carry the change, the pattern may be uneven between the two hands or two feet. BioMed Central
Gene–environment interaction
The main cause is genetic, but general prenatal health can subtly influence bone growth outcomes. BioMed Central
Overlapping phenotypes with other brachydactyly genes
Different genes (e.g., IHH, BMPR1B, GDF5) can produce short digits; in rare cases they can mimic BSS patterns. Osmosis
Syndactyly-specific gene effects
Some variants mainly affect digit separation; when they co-occur with brachydactyly changes, both features appear. radiopaedia.org
Metacarpal/metatarsal involvement
Some people have shortened hand/foot rays beyond the phalanges, adding to overall hand/foot shortening. Genetic Rare Diseases Center
Embryonic timing differences
Even small shifts in when digits split or bones ossify can change final length and webbing. BioMed Central
Genetic background in different populations
The same variant can show different average severity in different groups due to other background genes. BioMed Central
Epigenetic influences
Chemical tags that turn genes “up or down” may modify severity without changing the DNA code itself. BioMed Central
Chance developmental variation
Even with the same genes, small random differences in development can alter bone length a little bit. BioMed Central
Classification choices
What doctors call “BSS” vs “A4 with syndactyly” often reflects how a clinic classifies the pattern, not a different cause. BioMed Central

Symptoms

Not everyone has all features. Many people are otherwise healthy. Symptoms are mostly about shape, movement, function, and feelings about appearance.

Short fingers (one or several)
Middle or end finger bones are short, so the finger looks shorter and the fingertip sits lower than neighbors. BioMed Central
Short toes
Toes may lack a middle bone or have a small one, most often toes 2–5; the foot can look compact. Genetic Rare Diseases Center
Joined toes (webbing)
Soft-tissue webbing between toes 2 and 3 is common; it may be partial or extend most of the way. radiopaedia.org
Occasional finger webbing
Some people have mild webbing between fingers; this rarely limits function when it is shallow. radiopaedia.org
Broad, short thumbs
The end thumb bone can be wide and short, which can change grip or pinch in some tasks. malacards.org
Grip differences
Pinching small objects or fine manipulation may feel different; many people adapt with practice. BioMed Central
Shoe fit issues
Toe webbing or short toes can change toe spacing; wide toe boxes may feel better. BioMed Central
Cosmetic concerns
Some people feel self-conscious about the look of hands or feet; counseling or support groups can help. Genetic Rare Diseases Center
Calluses or pressure points
Different toe lengths may change pressure when walking, leading to calluses in some people. BioMed Central
Stiffness in certain joints
Short bones can slightly change joint angles; stretching and hand therapy can keep joints flexible. BioMed Central
Difficulty with rings or gloves
Finger shape can affect sizes; custom sizing often solves this. BioMed Central
Nail shape differences
Shorter or broader nail plates may be present on affected digits. BioMed Central
Family pattern
Seeing similar hands/feet in a parent or sibling often reassures families about what to expect. BioMed Central
Usually normal growth and development otherwise
BSS mainly affects hands and feet; most people have normal overall health. BioMed Central
Emotional impact varies
Some people are unbothered; others want options to change the look or function. Shared decision-making is key. BioMed Central

Diagnostic tests

A) Physical examination (bedside assessment)

General limb look and symmetry
The clinician observes hand and foot size, finger and toe lengths, and whether both sides match. This quick, no-equipment check helps spot which digits are affected.
Digit-by-digit length check
The doctor compares each finger and toe with standard expectations. Shortening in the middle or end bones suggests a brachydactyly pattern. BioMed Central
Web space inspection
They look between digits for skin webbing, how far it extends, and whether nails share a fold. This defines syndactyly severity. radiopaedia.org
Joint motion range
Gentle bending and straightening of each joint shows stiffness or extra looseness. This guides therapy plans. BioMed Central
Grip and pinch testing
Simple tasks like picking up a coin or buttoning show how the hand works in daily life.

B) Manual/functional tests (hands-on performance)

Functional hand tests
Timed pegboards or simple pick-up tasks measure fine motor control. These tests track progress with therapy.
Power grip and key pinch
Squeezing a dynamometer or pinching a gauge measures strength. Results help decide if adaptive tools are needed.
Gait and footwear assessment
Walking pattern and shoe wear are checked. Short toes or webbing can shift pressure, so the clinician may suggest insoles.
Activities of daily living (ADL) screen
Short surveys ask about writing, typing, cooking, dressing, and sports. Answers guide practical support.
Pain and fatigue scales
Even if the condition is structural, some people report aching after long use. Rating scales monitor comfort over time.

C) Laboratory and pathological tests

Genetic testing for HOXD13 and related genes
DNA analysis (single-gene, panels, or exome) can confirm a HOXD13 variant and support the diagnosis, help with family counseling, and inform recurrence risk. sciencedirect.com
Variant classification by a clinical lab
The lab labels a change as pathogenic, likely pathogenic, or uncertain. This uses international rules and family data.
Parental testing (segregation analysis)
Testing parents shows whether the variant is inherited or new (de novo). This helps with risk to future children. BioMed Central
Targeted testing for differential genes
If the pattern is unusual, doctors may check other brachydactyly genes (e.g., IHH, BMPR1B, GDF5) to rule in or out look-alike conditions. Osmosis
Basic metabolic tests (rarely needed)
Routine labs are usually normal. They may be used to exclude very rare metabolic causes of limb anomalies when history suggests it. BioMed Central

D) Electrodiagnostic tests

Nerve conduction studies
These are not typically needed because BSS is a bone/soft-tissue pattern. They may be used if symptoms suggest an unrelated nerve issue (numbness, tingling) to exclude other causes.
Electromyography (EMG)
Also not routine in BSS. Used only if there is weakness or suspected nerve/muscle disease from another cause. The goal is to avoid unnecessary testing.

E) Imaging tests

Plain X-rays of hands and feet
This is the main imaging test. X-rays show which bones are short, whether a middle bone is missing, and whether any bones are fused. This confirms the brachydactyly pattern and the level of syndactyly. BioMed Central
X-ray bone age (sometimes)
In children, a bone-age film can show how the growth plates are maturing. It can help predict final length in some cases.
Ultrasound or MRI (selected cases)
Most people do not need these. They are used if surgeons need to plan complex separation, check tendons, or assess unusual bone fusions before an operation. radiopaedia.org

Non-pharmacological treatments (therapies and other supports)

Early parent education & home care
What it is: Honest, simple guidance about safe positioning, skin care between joined digits, and when to call the clinic.
Purpose: Reduces anxiety, promotes safe daily care.
How it helps: Clear routines prevent skin irritation and support normal play. chop.edu
Occupational therapy (OT)
What it is: Play-based activities to build fine-motor skills (grasping toys, feeding, drawing).
Purpose: Maximizes hand function early.
How it helps: Repeated gentle tasks strengthen small hand muscles and improve coordination. chop.edu
Physical therapy (PT)
What it is: Age-appropriate exercises for strength, range of motion, posture.
Purpose: Keeps joints supple and supports whole-arm use.
How it helps: Gentle stretching and movement protect joint mobility and gross motor milestones. chop.edu
Adaptive tools
What it is: Modified pencils, grips, wide-handled utensils, button hooks.
Purpose: Makes school and self-care easier.
How it helps: Larger, softer grips reduce effort and improve control.
Activity modification
What it is: Adjusting tasks (shorter practice intervals, choosing sports with less finger load).
Purpose: Prevents overuse and skin problems.
How it helps: Keeps kids active while protecting the digits.
Protective splinting (short-term)
What it is: Soft splints or buddy taping in specific cases (guided by clinicians).
Purpose: Protects healing skin after procedures or injuries.
How it helps: Limits strain and rubbing during recovery. chop.edu
Scar care after surgery
What it is: Massage, moisturizing, sunscreen, sometimes silicone gel sheets once healed.
Purpose: Softer, flatter scars that move better.
How it helps: Gentle pressure and hydration help scar remodeling. chop.edu
Desensitization therapy
What it is: Gradual exposure to textures (cotton → towel → rice) after surgery.
Purpose: Reduces tenderness and touch-avoidance.
How it helps: The nervous system adapts to normal touch.
Sensory-motor play
What it is: Playdough, blocks, stacking, bead threading.
Purpose: Builds precision grip and finger independence.
How it helps: Repetition strengthens fine-motor patterns.
School accommodations
What it is: Extra time for writing, keyboard use, alternative testing.
Purpose: Ensures fair access to learning.
How it helps: Removes barriers from hand speed or endurance limits.
Psychosocial support
What it is: Age-appropriate counseling, peer groups.
Purpose: Encourages healthy body image and confidence.
How it helps: Kids learn language to explain their hand difference.
Genetic counseling
What it is: Family-centered talk about inheritance and future planning.
Purpose: Informs recurrence risk and testing options.
How it helps: Supports decisions for future pregnancies. Orpha
Wound-care teaching
What it is: Hand-washing, gentle dressing changes, watching for redness.
Purpose: Prevents infection and speeds healing.
How it helps: Consistent care reduces complications after release surgery. chop.edu
Hand-use habit training
What it is: Rewarding the use of the affected hand in daily play.
Purpose: Prevents “learned non-use.”
How it helps: Builds strength and symmetry.
Home exercise plans
What it is: Short daily routines from OT/PT.
Purpose: Maintains gains between clinic visits.
How it helps: Small, regular practice compounds progress.
Ergonomics for teens/adults
What it is: Adjusting keyboards, tools, and workstation height.
Purpose: Reduces strain with prolonged use.
How it helps: Neutral wrist and supportive grips lower fatigue.
Sports guidance
What it is: Choosing well-fitted gloves, taping techniques, gradual return.
Purpose: Keeps kids active safely.
How it helps: Protection prevents blisters and sprains.
Nutrition for healing
What it is: Regular protein, fruits/vegetables, and adequate vitamin C, D, calcium, zinc from food.
Purpose: Supports skin and bone health.
How it helps: Nutrients assist collagen formation and mineralize growing bone. ods.od.nih.gov+4ods.od.nih.gov+4ods.od.nih.gov+4
Sun protection for scars
What it is: Clothing or sunscreen after healing.
Purpose: Prevents scar darkening.
How it helps: Limits UV-related discoloration.
Regular follow-up
What it is: Periodic surgeon/therapy checks as the child grows.
Purpose: Monitors growth and function, and times surgery well.
How it helps: Adjusts the plan to changing hands and goals. chop.edu

Drug treatments

Important: There is no medicine that “fixes” congenital fusion or short bones. Medicines here support pain control, anesthesia, infection treatment (if needed), nausea control, and skin care—especially around surgery. Always use clinician-directed, weight-based dosing and check the exact FDA label linked below.

Acetaminophen (paracetamol)
Class: Analgesic/antipyretic. Typical use/time: Regularly for short periods after procedures; oral or IV per clinician. Purpose: First-line pain/fever relief. Mechanism: Central COX inhibition to reduce pain signals. Side effects: Generally well tolerated; watch total daily dose to avoid liver injury. Label: FDA acetaminophen injection prescribing info. FDA Access Data
Ibuprofen
Class: NSAID. Use/time: Short courses for pain and swelling if surgeon approves. Purpose: Decreases post-operative soreness. Mechanism: COX-1/COX-2 inhibition to reduce prostaglandins. Side effects: Stomach upset, rare kidney effects; avoid if surgeon restricts NSAIDs. Label: FDA oral suspension label. FDA Access Data+1
Naproxen / Naproxen sodium
Class: NSAID. Use: Alternative to ibuprofen in older children/teens/adults if appropriate. Purpose: Longer-acting pain relief. Mechanism: COX inhibition. Side effects: Similar NSAID cautions; dose per label. Label: NAPROSYN/Naprelan labels. FDA Access Data+2FDA Access Data+2
Lidocaine (local anesthetic, injection)
Class: Amide local anesthetic. Use/time: During procedures/blocks. Purpose: Numbs area so surgery can be performed without pain. Mechanism: Na⁺ channel blockade in nerves. Side effects: Rare systemic toxicity if overdosed. Label: Xylocaine injection. FDA Access Data
Bupivacaine (local anesthetic, injection)
Class: Long-acting local anesthetic. Use: Nerve blocks/wound infiltration to reduce pain for many hours. Mechanism: Na⁺ channel blockade. Side effects: Rare cardiotoxicity with intravascular dosing—expert use only. Label: Bupivacaine/Marcaine. FDA Access Data+1
Amoxicillin-clavulanate
Class: β-lactam/β-lactamase inhibitor antibiotic. Use: Only when a clinician diagnoses or strongly suspects infection. Purpose: Treats likely skin/soft-tissue bacteria. Mechanism: Inhibits bacterial cell-wall synthesis; clavulanate blocks β-lactamases. Side effects: GI upset, rash; dose by weight. Label: AUGMENTIN. FDA Access Data
Cephalexin
Class: 1st-gen cephalosporin. Use: Skin/soft-tissue infections when indicated. Purpose: Covers common skin bacteria like staph/strep. Mechanism: Cell-wall synthesis inhibitor. Side effects: GI upset, allergy in penicillin-allergic patients. Label: KEFLEX. FDA Access Data
Clindamycin
Class: Lincosamide antibiotic. Use: For patients with β-lactam allergy or specific clinical needs. Purpose: Skin/soft-tissue infections, anaerobic coverage. Mechanism: Inhibits bacterial protein synthesis (50S). Side effects: Diarrhea, risk of C. difficile. Label: CLEOCIN. FDA Access Data
Ondansetron
Class: 5-HT3 antagonist antiemetic. Use: Prevent/treat post-operative nausea. Purpose: Keeps fluids/food down during recovery. Mechanism: Blocks serotonin receptors in gut/brain. Side effects: Headache, rare QT prolongation. Label: ZOFRAN Injection. FDA Access Data+1
Diphenhydramine (when clinically appropriate)
Class: Antihistamine. Use: Itch or allergic reactions; sometimes given before certain infusions. Purpose: Symptom control. Mechanism: H1 receptor blockade. Side effects: Drowsiness; not for infants without clinician guidance. Label: FDA injection label. FDA Access Data
Topical first-aid antibiotic products (OTC monograph)
Class: Bacitracin ± neomycin ± polymyxin combinations. Use: Minor, superficial wound care if advised. Purpose: Lowers superficial bacterial load on small abrasions. Mechanism: Topical antimicrobial action. Side effects: Local allergy in some people. FDA monograph/labels: First-aid antibiotic monograph; examples include NEOSPORIN/CORTISPORIN ophthalmic/otic—use only as directed by clinicians. FDA Access Data+3FDA Access Data+3FDA Access Data+3
Gabapentin (selected cases, older children/adults)
Class: Anticonvulsant used off-label for neuropathic pain features if present. Purpose: Helps nerve-type pain after major surgery in specific cases. Mechanism: Modulates calcium channels in CNS. Side effects: Drowsiness, dizziness. Label: NEURONTIN. FDA Access Data+1
Acetaminophen (oral/rectal forms)
Class: Analgesic/antipyretic. Use: Home pain/fever dosing with clear daily maximums. Purpose/Mechanism: As in #1. Side effects: Liver risk with overdose—track all combination products. Label: FDA acetaminophen injection label includes cross-route daily max guidance. FDA Access Data
Nasal or oral decongestants are not routine
Reason: No role in hand healing; may have side effects and are unnecessary unless treating a separate diagnosis. (General safety principle; follow clinician advice.)
Strong opioids (e.g., oxycodone) are rarely needed
Use: Briefly for severe post-op pain only if non-opioids are inadequate and prescriber deems necessary. Risks: Dependence, respiratory depression—extra caution around children and homes with children; consider take-home naloxone when appropriate. Label: Oxycodone warnings. FDA Access Data+1
**Codeine-containing products are usually avoided in children
Reason: Risk of life-threatening respiratory depression in ultra-rapid metabolizers—boxed warnings. Safer alternatives are preferred. Label: Codeine safety. FDA Access Data+2FDA Access Data+2

(Your surgical/therapy team will tailor any medicine plan to age, weight, and the exact procedure. Always rely on the specific label and your clinician.)

Dietary molecular supplements

Key point: No supplement corrects the anatomy. Food should be the main source. If a clinician recommends supplements, these general roles apply:

Vitamin C – helps your body make collagen for skin and scar healing; citrus, berries, peppers are great food sources. Supplement only if diet is low. ods.od.nih.gov+1
Vitamin D – supports calcium absorption and bone health; sunlight, fortified milk/fish help; dose only under guidance to avoid toxicity. ods.od.nih.gov+1
Calcium – main mineral for bones/teeth; dairy, leafy greens, tofu; supplement if dietary intake is inadequate. ods.od.nih.gov+1
Zinc – important for wound healing and immunity; meats, beans, nuts; excess can upset copper balance. ods.od.nih.gov+1
Protein (whey/casein/soy, if needed) – building block for tissue repair when food intake is low post-op; prioritize balanced meals first. (General nutrition principle supported by ODS “healing” nutrients above.) ods.od.nih.gov
Omega-3 fatty acids (EPA/DHA) – help temper inflammatory signaling; best from fish (salmon, sardines). Supplements only if diet is low and surgeon agrees, especially around surgery timing. ods.od.nih.gov
Vitamin A (within safe limits) – supports epithelial healing; prefer food (eggs, dairy, orange vegetables). Avoid excess. (General nutrition caution; see ODS framework.) ods.od.nih.gov
Vitamin K (food first: greens) – partners with calcium in bone; avoid high-dose supplements unless prescribed. (Bone/ODS context.) ods.od.nih.gov
Iron (if deficient only) – for energy and healing; supplement strictly by lab guidance. (Standard ODS approach.) ods.od.nih.gov
Multivitamin (age-appropriate, if diet is limited) – gap-filler, not a cure; choose reputable brands and avoid mega-doses. (General ODS guidance about prudent supplementation.) ods.od.nih.gov

Immunity-booster / Regenerative / Stem-cell drugs

Important reality check: There are no approved “immunity-booster” or regenerative drugs that fix brachydactyly or syndactyly. Some medicines support comfort during healing, and reconstructive surgery does the anatomical correction. “Stem cell” treatments are not standard of care here. Below are supportive categories sometimes discussed—not cures:

Vaccinations (age-appropriate schedule) – protect against infections during childhood; follow national schedules via your pediatrician. Function: primes immune system; Mechanism: antigen-specific immunity. (Standard pediatric practice; your clinician will advise.)
Topical antimicrobials (see above) – used for small, superficial wounds if advised. Function: lowers surface bacteria; Mechanism: local antimicrobial action. FDA Access Data
Probiotics (food-based like yogurt; supplement only if advised) – may support gut balance during antibiotic courses; not a hand-healing treatment. Function: microbiome support; Mechanism: beneficial bacteria. (General nutrition perspective.)
Gabapentin (when indicated) – reduces neuropathic-type pain signals to allow better therapy participation. Function: comfort; Mechanism: calcium channel modulation. FDA Access Data
Vitamin D (if low) – supports bone mineralization. Function: calcium absorption; Mechanism: nuclear receptor effects. ods.od.nih.gov
Omega-3s (dietary) – modulate inflammatory signaling; not tissue regrowth. Function: comfort; Mechanism: eicosanoid balance. ods.od.nih.gov

Surgeries

Syndactyly release (simple webbing)
Procedure: Careful separation of joined skin and reconstruction of the web space, often with small skin grafts.
Why: Improves finger independence, growth, and fine-motor function. Timing: Often before age 1–2 years depending on which fingers are involved. chop.edu
Complex release (with bone involvement)
Procedure: Separates digits and may reshape bone or joints.
Why: Prevents deformity from fused bones and helps growth stay aligned. chop.edu
Nailfold reconstruction
Procedure: Recreates natural nail edges and folds after separation.
Why: Reduces snagging, improves looks and hygiene. chop.edu
Web-space deepening and flap techniques
Procedure: Special skin flaps keep the web deep and flexible.
Why: Protects function and reduces contracture risk. chop.edu
Revision surgery (as the child grows, if needed)
Procedure: Minor touch-ups for tight scars or web creep.
Why: Keeps range of motion and hand function optimal through growth. chop.edu

Preventions

We can’t “prevent” a congenital difference that already exists, but we can prevent complications and support healthy growth:

Keep skin dry/clean between digits; pat dry after bathing.
Use well-fitting shoes/gloves to avoid rubbing.
Follow wound-care and dressing instructions exactly after any procedure.
Keep all therapy and follow-up appointments to catch issues early.
Use sunscreen or clothing on healed scars.
Encourage regular play that uses both hands.
Teach safe tool use and sports techniques.
Eat balanced meals (protein + fruits/veg + calcium-rich foods). ods.od.nih.gov+1
Keep vaccinations up to date (general pediatric health).
Seek timely medical care for redness, swelling, fever, or pain that’s getting worse. chop.edu

When to see a doctor

New redness, swelling, warmth, or discharge around digits or scars.
Fever or pain that keeps worsening after a procedure.
Splints or casts that feel too tight, cause numbness/tingling, or change finger color.
Any concern about hand function, school tasks, sports participation, or scar tightness.
Questions about timing of surgery or genetic testing options. chop.edu

Foods to favor and to limit

Eat more of:

Milk/yogurt (or fortified alternatives) for calcium + vitamin D. ods.od.nih.gov
Oily fish (salmon, sardines) for omega-3s. ods.od.nih.gov
Eggs and lean meats for high-quality protein and zinc. ods.od.nih.gov
Beans/lentils for plant protein and minerals.
Leafy greens (spinach, kale) for vitamin K/calcium. ods.od.nih.gov
Citrus, berries, peppers for vitamin C (healing). ods.od.nih.gov
Nuts/seeds for healthy fats.
Whole grains for steady energy.
Colorful vegetables for overall micronutrients.
Plenty of water for hydration.

Limit/avoid:

Sugary drinks (empty calories).
Ultra-processed snacks high in salt.
Excess candy/desserts.
Energy drinks/caffeine for kids.
Very salty packaged foods (swelling).
High-dose supplements without medical advice. ods.od.nih.gov
Herbal products that claim to “regrow bone/fingers.”
Alcohol (teens/adults) during recovery.
Smoking/vaping in the household (impairs wound healing).
NSAIDs against surgeon advice around surgery timing. (Always follow your surgical team’s plan.)

Frequently Asked Questions (FAQs)

1) Will medicines make the fingers separate or grow longer?
No. Medicines do not change the anatomy. Surgery and therapy improve function and appearance; medicines mainly control pain, nausea, or treat infection if it occurs. chop.edu

2) What age is best for separating joined fingers?
Many centers aim for before age 1–2 years, sooner if the thumb or little finger is involved or if bones are fused. Your surgeon will individualize timing. chop.edu

3) Is BDSD always genetic?
Not always. Some families have a gene change; others do not. Genes like HOXD13 are known in related conditions. Genetic counseling can help. pubmed.ncbi.nlm.nih.gov

4) Will my child be able to write, play instruments, or do sports?
Most children do very well with early surgery (when needed), therapy, and adaptive tools. Function improves with practice. chop.edu

5) Are there long-term problems after surgery?
Some children need revision if scars tighten or the web creeps. Regular follow-up helps catch this early. chop.edu

6) Do I need to clean between joined toes/fingers a special way?
Yes—gentle soap and water, pat dry, and follow clinician instructions to keep the area clean and dry. chop.edu

7) Which pain medicine is safest?
Doctors often start with acetaminophen and may add ibuprofen/naproxen if appropriate. Opioids are rarely needed and have serious risks, especially in children. Always follow label and clinician advice. FDA Access Data+3FDA Access Data+3FDA Access Data+3

8) Why avoid codeine in children?
Some children metabolize codeine into morphine too quickly, which can cause life-threatening breathing problems. This risk led to strong FDA warnings. FDA Access Data+1

9) Do supplements help healing?
Food first. If diet is limited, a clinician may suggest vitamin C, D, calcium, or zinc at safe doses; they support healing and bone health but don’t change anatomy. ods.od.nih.gov+3ods.od.nih.gov+3ods.od.nih.gov+3

10) Can therapy alone replace surgery?
Therapy maximizes function, but if digits are fused, surgery is the way to separate them. Therapy then builds skill. chop.edu

11) Is syndactyly common?
Syndactyly is the most common limb difference (about 1 in 2,000–3,000 births). chop.edu

12) Will my child need imaging?
Simple X-rays show whether bones are fused and help plan surgery. chop.edu

13) Can this affect feet too?
Yes. BDSD often includes specific toe involvement (e.g., 2nd–3rd toes in Zhao type). Orpha

14) Will school need to know?
Yes—teachers can provide accommodations (keyboarding, extra time) to support learning.

15) How often are follow-ups?
Typically at 2 weeks, 6 weeks after surgery, and then periodically through early childhood to track growth and function. chop.edu

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: November 01, 2025.

PDF Documents For This Disease Condition

References

SaveSavedRemoved 0