In recent years there have been some changes in the treatment of congenital syndactyly. Nowadays treatment is started in the first year of life, before the child uses his hands purposefully. In the University Hospital of the Free University of Amsterdam 31 patients with 61 congenital syndactylies in 45 hands were treated between 1971 and 1991. The results were good in 40, fair in 15, moderate in 4 and poor in 2 corrections. Surgery was performed under general anaesthesia and whenever possible on an out-patient basis. To split the fingers zig-zag incisions are used. For web reconstruction two triangular flaps or one rectangular flap are used. Complex syndactyly is treated in two sessions: first two double opposing palmar flaps to cover the tips and to form the nail walls are raised and after two weeks the rest of the syndactyly is corrected. Postoperative treatment consists of a compression bandage for two weeks, followed by bathing and training in warm water until all wounds have healed.