Figure 13.

Complex syndactyly. (a) The D-shaped duplicated proximal phalanx of the index finger was whittled down using a #15 blade because all impact tools such as a chisel might have destroyed the epiphysis. The operation was done when the child was 22 months of age. (b) Remodeling was proceeding satisfactorily 2 years after surgery. (c, d) The epiphysis continues to grow normally. The patient is right-handed and plays the violin. Parts a, b, and d were reprinted with permission from Flatt AE, 1971. Part c was reprinted from Wood VE, 1970, with permission from The Journal of Bone and Joint Surgery, Inc.