Double Nail-identifying a Unique and Rare Condition

A 10-year-old boy had fusion of his fingers and nails from birth. Similar lesions had already been noticed in the mother and maternal grandmother. Although an X-ray was recommended, the patient chose not to follow up. Upon examination, the ring and middle fingers with fused nails seen bilaterally [Figure 1a and b]. The diagnosis was made using the Montagu type of syndactyly, type-1c, which is the most recent classification.[1] Synonychia is the term for the fusion of one or both nails. Conjoint nail is another name for it. Syndactyly is a congenital condition that causes neighbouring digits to fuse together. It may be complete or incomplete, and it may be simple or complex. Toe or finger webs in simple syndactyly consist of soft tissues and skin, but in complex syndactyly, the bones and nails are joined. Despite being a solitary disorder more frequently than not, the condition may be associated with syndromes.Figure 1: (a) Fusion of the complete ring and middle finger (black arrow). (b) Close view showing synonychia of the ring and middle finger nail (black arrow)Declaration of patient consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published, and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.