Long-Term Patient-Centered Outcomes After Congenital Syndactyly Reconstruction: Aesthetic, Functional, and Psychosocial Assessment

Background and Objectives: Syndactyly is a common congenital hand anomaly that may affect hand appearance, function, and psychosocial well-being. This study aimed to evaluate long-term patient-centered outcomes after congenital syndactyly reconstruction, including aesthetic, functional, and psychosocial domains. Methods: This retrospective study included 53 patients with 90 reconstructed web spaces. Aesthetic outcomes were assessed using the Withey score, functional outcomes using the QuickDASH questionnaire, and psychosocial outcomes using an exploratory patient-centered survey developed by the authors. Results: The median follow-up duration was 10 years. The median outcome scores suggested generally favorable long-term results, with a Withey score of 2, a QuickDASH score of 14, and a psychosocial survey score of 29, all within the favorable range of their respective scales. Poorer aesthetic outcomes were observed in patients with complicated syndactyly, those who underwent surgery between 1 and 5 years of age, and those who underwent multiple surgeries. Female sex was associated with poorer functional and psychosocial scores. Complicated syndactyly was associated with less favorable outcomes across all domains. The psychosocial survey demonstrated high internal consistency and significant correlations with both functional and aesthetic outcomes. Conclusions: Congenital syndactyly reconstruction was associated with generally favorable long-term patient-centered outcomes. Less favorable results were observed particularly in patients with complicated syndactyly, while age- and surgery-related associations should be interpreted cautiously because of the retrospective design. These findings support the importance of individualized counseling and long-term assessment that includes aesthetic, functional, and psychosocial dimensions.