Introduction Congenital digital stiffness that comes in two forms hereditary symphalangism nonherediatry symphalangism Epidemiology Anatomic location more common in ulnar digits Etiology Pathophysiology failure of IP joint to differentiate during development Genetics inheritance pattern (hereditary type) autosomal dominant Associated conditions syndactyly (nonhereditary type) Apert's syndrome (nonhereditary type) Poland's syndrome (nonhereditary type) correctable hearing loss (hereditary type) Presentation Physical exam inspection absence of flexion and extension creases motion stiff digits Imaging Radiographs IP joint space may appear narrow Treatment Nonoperative observation no indication for surgery in children Operative capsulectomy outcome login to view 1 more bullet IP joint arthroplasty outcome login to view 1 more bullet angular osteotomy indications login to view 1 more bullet arthrodesis indications login to view 2 more bullets