the beginning, then the second and the third interdigital web spaces have to be freed. The clinodactyly of the thumb has to be corrected as well. The lengthening of the thumb phalanx may be needed, thus increasing the first web space. In both type I and type II, the recurrent syndactyly of the second web space will occur because of a pseudoepiphysis at the base of the index metacarpal. This should be corrected by later revisions. Type III hands are the most challenging to treat because of their complexity. First of all, it is advised to release the first and fourth webspace, thus converting it to type I hand. The treatment of macerations and nail-bed infections should also be done in the beginning. For increasing of the first web space, lengthening of the thumb can be done. It is suggested that in severe cases an amputation of the index finger should be considered. However, before making this decision, it is important to weigh the potential improvement to be achieved against the possible psychological problems of the child later due to the aesthetics of the hand. Later, the second and/or third interdigital web space should be released. With growing of a child and respectively the hands, secondary revisions are needed to treat the contractures and to improve the aesthetics. See also Other craniosynostosis syndromes: Crouzon syndrome Muenke syndrome Pfeiffer syndrome Saethre–Chotzen syndrome Hearing loss with craniofacial syndromes References External links GeneReviews/NIH/NCBI/UW entry on FGFR-Related Craniosynostosis Syndromes Cell surface receptor deficiencies Congenital oral disorders Genodermatoses Hearing loss with craniofacial syndromes Pharyngeal arches Rare syndromes